Provider Demographics
NPI:1952558181
Name:JONES, JENNIFER JACKSON (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JACKSON
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:JENNIFER'
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MFTI
Mailing Address - Street 1:1625 W OLYMPIC BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3809
Mailing Address - Country:US
Mailing Address - Phone:323-999-2404
Mailing Address - Fax:310-782-9631
Practice Address - Street 1:1625 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3809
Practice Address - Country:US
Practice Address - Phone:323-999-2404
Practice Address - Fax:310-786-9631
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA97584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist