Provider Demographics
NPI:1871057471
Name:JENKINS, JENA LEE
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:LEE
Last Name:JENKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26033 GETTY DR UNIT 421
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-0977
Mailing Address - Country:US
Mailing Address - Phone:734-883-4950
Mailing Address - Fax:
Practice Address - Street 1:26033 GETTY DR UNIT 421
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-0977
Practice Address - Country:US
Practice Address - Phone:734-883-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst