Provider Demographics
NPI:1740465541
Name:JENSEN, DEXTER ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:DEXTER
Middle Name:ANTHONY
Last Name:JENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:D. ANTHONY
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1955 CITRACADO PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4113
Mailing Address - Country:US
Mailing Address - Phone:760-294-1281
Mailing Address - Fax:760-888-2175
Practice Address - Street 1:1955 CITRACADO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4113
Practice Address - Country:US
Practice Address - Phone:760-294-1281
Practice Address - Fax:760-888-2175
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA679602084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry