Provider Demographics
NPI:1982925616
Name:BUTERA, JENIFER (LMFT)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:BUTERA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:BUTERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:1260 LAKE BLVD
Mailing Address - Street 2:SUITE 242
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-2614
Mailing Address - Country:US
Mailing Address - Phone:530-771-2308
Mailing Address - Fax:530-771-2309
Practice Address - Street 1:1260 LAKE BLVD
Practice Address - Street 2:SUITE 242
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-2614
Practice Address - Country:US
Practice Address - Phone:530-771-2308
Practice Address - Fax:530-771-2309
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39219106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist