Provider Demographics
NPI:1205285400
Name:LE, JENNY NHU (BEHAVIOR TECHNICIAN)
Entity type:Individual
Prefix:MS
First Name:JENNY
Middle Name:NHU
Last Name:LE
Suffix:
Gender:F
Credentials:BEHAVIOR TECHNICIAN
Other - Prefix:MS
Other - First Name:JENNY
Other - Middle Name:NHU
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BEHAVIOR TECHNICIAN
Mailing Address - Street 1:4952 WARNER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-5506
Mailing Address - Country:US
Mailing Address - Phone:918-810-6763
Mailing Address - Fax:
Practice Address - Street 1:4952 WARNER AVE STE 300
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-5506
Practice Address - Country:US
Practice Address - Phone:918-810-6763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CAPT36184167G00000X
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician