Healthcare Provider Details

I. General information

NPI: 1295124451
Provider Name (Legal Business Name): JENNIFER BROOKE STROHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8607 IMPERIAL HWY STE 208
DOWNEY CA
90242-3947
US

IV. Provider business mailing address

8607 IMPERIAL HWY STE 208
DOWNEY CA
90242-3947
US

V. Phone/Fax

Practice location:
  • Phone: 310-795-9365
  • Fax:
Mailing address:
  • Phone: 310-795-9365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number120553528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: