Provider Demographics
NPI:1922378751
Name:BENSON, JENNIFER JESSIE (LMFT #86969)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:JESSIE
Last Name:BENSON
Suffix:
Gender:F
Credentials:LMFT #86969
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010-A HARBISON DR # 221
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687
Mailing Address - Country:US
Mailing Address - Phone:707-880-8622
Mailing Address - Fax:
Practice Address - Street 1:311 CALIFORNIA ST
Practice Address - Street 2:SUITE 750
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104
Practice Address - Country:US
Practice Address - Phone:707-880-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86969106H00000X
CAIMF 73391106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist