Individual
JENNIFER MARIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
8560
MA
103T00000X
Psychologist
PSY18970
CA
103TC0700X
Clinical Psychologist
18970
CA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY18970
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18970
LICENSE
CA
01
—
8560
LICENSE
MA
Enumeration date
03/29/2006
Last updated
07/02/2024
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