Individual
BENJAMIN W. JENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
71 N MAIN ST, TEMPLETON, CA 93465-5326
(805) 434-3829
(805) 434-3839
Mailing address
71 N MAIN ST, TEMPLETON, CA 93465-5326
(805) 434-3829
(805) 434-3839
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 21750
CA
1041C0700X
Clinical Social Worker
LW00009154
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCS 21750
CA BOARD OF BEHAVIROL SCIENCES
CA
01
—
LW00009154
STATE MEDICAL LICENSE
WA
Enumeration date
07/17/2008
Last updated
04/16/2014
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