Provider Demographics
NPI:1821347147
Name:FRANDSEN, JILL A (MFT 91194)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:A
Last Name:FRANDSEN
Suffix:
Gender:F
Credentials:MFT 91194
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 60710
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93160-0710
Mailing Address - Country:US
Mailing Address - Phone:805-455-2804
Mailing Address - Fax:
Practice Address - Street 1:735 STATE ST STE 104
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5502
Practice Address - Country:US
Practice Address - Phone:805-455-2804
Practice Address - Fax:805-764-8639
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist