Provider Demographics
NPI:1780211896
Name:JERMAN, LORI MILDRED (LMFT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:MILDRED
Last Name:JERMAN
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 1:2307 FENTON PKWY # 107-239
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4746
Mailing Address - Country:US
Mailing Address - Phone:619-247-7107
Mailing Address - Fax:619-795-3274
Practice Address - Street 1:HEALTHY MINDS COUNSELING SERVICES
Practice Address - Street 2:1455 FRAZEE ROAD, SUITE 880
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-206-5271
Practice Address - Fax:619-795-3274
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24483106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist