Provider Demographics
NPI:1649420332
Name:PARLETTE, JENNIFER BENTON (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BENTON
Last Name:PARLETTE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 5TH AVE
Mailing Address - Street 2:STE. 101
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-1826
Mailing Address - Country:US
Mailing Address - Phone:415-306-0877
Mailing Address - Fax:
Practice Address - Street 1:1703 5TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-1826
Practice Address - Country:US
Practice Address - Phone:415-306-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT53514106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist