Provider Demographics
NPI:1770656308
Name:DENTON, JILL V (LMFT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:V
Last Name:DENTON
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:PO BOX 6359
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93412-6359
Mailing Address - Country:US
Mailing Address - Phone:805-534-1101
Mailing Address - Fax:805-534-1718
Practice Address - Street 1:2015 9TH ST
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-3209
Practice Address - Country:US
Practice Address - Phone:805-534-1101
Practice Address - Fax:805-534-1718
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT17282106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist