Individual
DR. JENNICA RACHEL JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LPC, LPCC, PPS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
PSYD CCU SANTA ANA
—
101YM0800X
Mental Health Counselor
EXAM PASS # 275107
—
101YP2500X
Professional Counselor
Primary
26
CA
101YP2500X
Professional Counselor
LPC6072
CO
101YS0200X
School Counselor
50164430
CA
146D00000X
Personal Emergency Response Attendant
TRAUMA AND LOSS CERT
—
1744R1102X
Research Study Specialist
ADOLESCENT
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26
CA BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
04/12/2011
Last updated
10/08/2014
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