Provider Demographics
NPI:1811172075
Name:SANTILLO, JENNIFER (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:SANTILLO
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 1:3855 ALAMO ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-2104
Mailing Address - Country:US
Mailing Address - Phone:805-577-2655
Mailing Address - Fax:
Practice Address - Street 1:3855 ALAMO ST STE A
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-2104
Practice Address - Country:US
Practice Address - Phone:805-577-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor