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Individual

GAYLE LYNNETTE JENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
4323 PALM AVE STE D, LA MESA, CA 91941-6597
(619) 972-5320
(619) 460-4019
Mailing address
4323 PALM AVE STE D, LA MESA, CA 91941-6597
(619) 972-5320
(619) 460-4019

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 20223
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0PL202230
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
06/09/2006
Last updated
02/09/2018
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