# PHYLLIS K. JENSEN, PSY.D.,L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306002803
- **Authorized official:** DR. PHYLLIS K. JENSEN PSY.D. (PSYCHOLOGIST)
- **Authorized official phone:** (941) 485-0854

## Contact information

- **Practice address:** 871 VENETIA BAY BLVD, SUITE 360, VENICE, FL 34285-8047
- **Practice address phone:** (941) 485-0854
- **Practice address fax:** (941) 480-9013
- **Mailing address:** 871 VENETIA BAY BLVD, SUITE 360, VENICE, FL 34285-8047
- **Mailing address phone:** (941) 485-0854
- **Mailing address fax:** (941) 480-9013

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | PY6912 | FL | Yes |

## Other

- **Enumeration date:** 08/04/2008
- **Last updated:** 05/27/2009