Provider Demographics
NPI:1841040011
Name:CLIFTON, JENNIFER DENISE
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:CLIFTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:DENISE
Other - Last Name:MURILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9631 BUSINESS CENTER DR STE D
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4545
Mailing Address - Country:US
Mailing Address - Phone:909-948-5747
Mailing Address - Fax:
Practice Address - Street 1:9631 BUSINESS CENTER DR STE D
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4545
Practice Address - Country:US
Practice Address - Phone:909-948-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW120355104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker