Doctor Name: | JENNIFER LYNN MERRILL |
NPI Number: | 1003111048 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCSW 29848 |
Business Practice Address: | 1529 Rollins Rd Burlingame, CA - 940102305 |
Business Phone Number: | 4156905495 |
Business Fax Number: | |
Mailing Address: | 1529 Rollins Rd, BURLINGAME |
State: | CA |
Postal Code: | 940102305 |
Phone Number: | 4156813211 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2011 |
NPI Last Update Date: | 04/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCSW 29848 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |