Provider Demographics
NPI:1356618631
Name:GLEIZER, JENNIFER ELIZABETH (LMFT106078)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:GLEIZER
Suffix:
Gender:F
Credentials:LMFT106078
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 TURTLE CREST DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-1008
Mailing Address - Country:US
Mailing Address - Phone:310-612-7027
Mailing Address - Fax:
Practice Address - Street 1:16341 VENUS DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-7733
Practice Address - Country:US
Practice Address - Phone:310-612-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66428106H00000X
CA106078106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist