Provider Demographics
NPI:1356599146
Name:KINSLEY, JANE LESLIE (LMFT)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:LESLIE
Last Name:KINSLEY
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 1:725 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-1924
Mailing Address - Country:US
Mailing Address - Phone:650-421-1905
Mailing Address - Fax:
Practice Address - Street 1:725 MAIN ST
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-1924
Practice Address - Country:US
Practice Address - Phone:650-421-1905
Practice Address - Fax:650-712-1809
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52538106H00000X
CAIMF 54588106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty