Provider Demographics
NPI:1851054399
Name:GOLD, JENNIFER (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GOLD
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 1:1230 ROSECRANS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2494
Mailing Address - Country:US
Mailing Address - Phone:310-561-1008
Mailing Address - Fax:
Practice Address - Street 1:440 E HUNTINGTON DR STE 311
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3776
Practice Address - Country:US
Practice Address - Phone:310-561-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist