Provider Demographics
NPI:1689160491
Name:JENNIFER C. WENDT, PH.D., PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:JENNIFER C. WENDT, PH.D., PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:WENDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-309-5956
Mailing Address - Street 1:17308 LIBERTAD DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-1335
Mailing Address - Country:US
Mailing Address - Phone:619-309-5956
Mailing Address - Fax:
Practice Address - Street 1:10531 4S COMMONS DR STE 477
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-3517
Practice Address - Country:US
Practice Address - Phone:619-309-5956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-04
Last Update Date:2018-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty