Healthcare Provider Details

I. General information

NPI: 1881429694
Provider Name (Legal Business Name): JENNA ZUSMAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6994 EL CAMINO REAL STE 205D
CARLSBAD CA
92009-4153
US

IV. Provider business mailing address

6994 EL CAMINO REAL STE 205D
CARLSBAD CA
92009-4153
US

V. Phone/Fax

Practice location:
  • Phone: 949-677-3049
  • Fax:
Mailing address:
  • Phone: 949-677-3049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: