Provider Demographics
NPI:1447302526
Name:CHUA, JENNIFER (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:CHUA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4124 NORD HWY
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9617
Mailing Address - Country:US
Mailing Address - Phone:530-966-5391
Mailing Address - Fax:
Practice Address - Street 1:4124 NORD HWY
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-9617
Practice Address - Country:US
Practice Address - Phone:530-966-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49086106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist