Provider Demographics
NPI:1598276586
Name:COHEN, JONNA ELISE (M ED, MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:ELISE
Last Name:COHEN
Suffix:
Gender:F
Credentials:M ED, MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 AVENIDA DE ORINDA STE 100
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2327
Mailing Address - Country:US
Mailing Address - Phone:925-385-8161
Mailing Address - Fax:
Practice Address - Street 1:61 AVENIDA DE ORINDA STE 100
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2327
Practice Address - Country:US
Practice Address - Phone:925-385-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111242101YM0800X, 106H00000X
CAIMF96642390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program