Provider Demographics
NPI:1689812992
Name:JENNINGS, JANIS (MFT, PHD)
Entity Type:Individual
Prefix:
First Name:JANIS
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MFT, PHD
Other - Prefix:
Other - First Name:JANIS
Other - Middle Name:
Other - Last Name:HOPKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 22703
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93121-2703
Mailing Address - Country:US
Mailing Address - Phone:805-568-1519
Mailing Address - Fax:805-845-3464
Practice Address - Street 1:22 W MICHELTORENA ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-6526
Practice Address - Country:US
Practice Address - Phone:805-568-1519
Practice Address - Fax:805-845-3464
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-23
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41438106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist