MEDICARE: DR. JESSICA VARTANYAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275906430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA VARTANYAN PSYD

Provider Business Mailing Address
First Line	:	1303 W VALENCIA DR # 244
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-4034
Country	:	US
Telephone Number	:	714-912-7211
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 W VALENCIA DR # 244
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92833-4034
Country	:	US
Telephone Number	:	714-912-7211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	01/04/2023

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