Healthcare Provider Details

I. General information

NPI: 1598953887
Provider Name (Legal Business Name): JESSICA NICOLE ELVIRA LMFT, PPSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11627 BROOKSHIRE AVE
DOWNEY CA
90241-4911
US

IV. Provider business mailing address

11627 BROOKSHIRE AVE
DOWNEY CA
90241-4911
US

V. Phone/Fax

Practice location:
  • Phone: 562-469-6500
  • Fax:
Mailing address:
  • Phone: 562-469-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT51952
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230016627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: