Provider Demographics
NPI:1669673570
Name:BRISCOE, JENNIFER GALINDO (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GALINDO
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:BERNARDO
Other - Last Name:GALINDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:298B BERNAL ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119
Mailing Address - Country:US
Mailing Address - Phone:408-780-0755
Mailing Address - Fax:
Practice Address - Street 1:298B BERNAL ROAD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119
Practice Address - Country:US
Practice Address - Phone:408-780-0755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
CA112522106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health