Provider Demographics
NPI:1487412979
Name:PATTERSON, JENNIFER DIANE (MA, LMFT 154647)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DIANE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MA, LMFT 154647
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32120 TEMECULA PKWY # 1034
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6801
Mailing Address - Country:US
Mailing Address - Phone:619-736-4711
Mailing Address - Fax:
Practice Address - Street 1:32120 TEMECULA PKWY # 1034
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6801
Practice Address - Country:US
Practice Address - Phone:619-736-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA154647106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist