Basic Information
| Provider Information | |||||||||
| NPI: | 1932472511 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SUAPAIA | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. L.M.F.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 299 W HILLCREST DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913607824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052934222 | ||||||||
| FaxNumber: | 8055838064 | ||||||||
| Practice Location | |||||||||
| Address1: | 1911 WILLIAMS DR STE 165 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930362612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059814233 | ||||||||
| FaxNumber: | 8059819268 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2012 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 86408 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.