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DR. JENNA KHOURY MOGANNAM PHD
NPI 1215644463
Psychologist - Clinical in San Mateo, CA

Active since October 27, 2022
116 E 25TH AVE STE C, SAN MATEO, CA 94403(415) 238-8513 Get Directions Write a Review

NPPES record last updated: October 27, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jenna Khoury Mogannam Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JENNA KHOURY MOGANNAM PHD (NPI 1215644463) is an individual clinical provider in San Mateo, California, licensed in California (33668) and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1215644463
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JENNA KHOURY MOGANNAMCredential: PHD
Location Address116 E 25TH AVE STE CSan Mateo, CA 94403-2596
Mailing Address116 E 25th Ave Ste CSan Mateo, CA 94403-2596
Phone(415) 238-8513
Sole ProprietorNo
Enumeration DateOctober 27, 2022
NPPES CertifiedOctober 27, 2022
✔ NPI 1215644463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 33668
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
116 E 25TH AVE STE C, San Mateo, CA 94403
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY BAUSBACK
Psychologist (Clinical)
116 E 25TH AVE STE C
SAN MATEO, CA 94403
San Mateo County (650) 336-0443

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jenna Mogannam's NPI number?

The NPI number for Jenna Mogannam is 1215644463. It was assigned to this individual provider in the NPPES registry on October 27, 2022.

Where is Jenna Mogannam located?

Jenna Mogannam practices at 116 E 25th Ave Ste C, San Mateo, CA 94403. The listed phone number is (415) 238-8513.

What is Jenna Mogannam's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Jenna Mogannam was last updated on October 27, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.