Individual
JENNIFER VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1247 7TH ST, SUITE 202, SANTA MONICA, CA 90401-1642
(310) 451-7871
(310) 455-2969
Mailing address
1247 7TH ST, SUITE 202, SANTA MONICA, CA 90401-1642
(310) 451-7871
(310) 455-2969
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY16386
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSY16386
LICENSE NUMBER
CA
Enumeration date
07/31/2006
Last updated
07/08/2007
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