Basic Information
Provider Information
NPI: 1184978314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZIEGLER
FirstName: JENNIFER
MiddleName: CLARE
NamePrefix:  
NameSuffix:  
Credential: B.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 17701 SAN PASQUAL VALLEY RD
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 920255301
CountryCode: US
TelephoneNumber: 7607414300
FaxNumber:  
Practice Location
Address1: 17701 SAN PASQUAL VALLEY RD
Address2:  
City: ESCONDIDO
State: CA
PostalCode: 92025
CountryCode: US
TelephoneNumber: 7607414300
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/09/2012
LastUpdateDate: 09/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X79634CAY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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