Individual
LILLIAN ELAINE JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTI, PCCI
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 788-2794
Mailing address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11587
CA
Other
Enumeration date
10/26/2017
Last updated
07/26/2022
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