Provider Demographics
NPI:1932647526
Name:BATTISTIN, JENNIE MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIE MARIE
Middle Name:
Last Name:BATTISTIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIE MARIE
Other - Middle Name:
Other - Last Name:NORGAARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:1201 S VICTORY BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2793
Mailing Address - Country:US
Mailing Address - Phone:747-271-2701
Mailing Address - Fax:310-693-5384
Practice Address - Street 1:1201 S VICTORY BLVD STE 206
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2793
Practice Address - Country:US
Practice Address - Phone:747-271-2701
Practice Address - Fax:310-693-5384
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT80423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist