1457044901 NPI number — MRS. JENNA ALYN MARKER LMFT

Table of content: MRS. JENNA ALYN MARKER LMFT (NPI 1457044901)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457044901 NPI number — MRS. JENNA ALYN MARKER LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARKER
Provider First Name:
JENNA
Provider Middle Name:
ALYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SMITH
Provider Other First Name:
JENNA
Provider Other Middle Name:
ALYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457044901
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22287 MULHOLLAND HWY # 193
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CALABASAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91302-5157
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-230-0338
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10380 WILSHIRE BLVD SUITE 1902
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGLES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-230-0338
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  134238 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)