Healthcare Provider Details

I. General information

NPI: 1992500243
Provider Name (Legal Business Name): PERFECTING SELFLOVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W IMPERIAL AVE STE R
EL SEGUNDO CA
90245-2287
US

IV. Provider business mailing address

100 W IMPERIAL AVE STE R
EL SEGUNDO CA
90245-2287
US

V. Phone/Fax

Practice location:
  • Phone: 323-445-0303
  • Fax:
Mailing address:
  • Phone: 323-445-0303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. LESTER RENEE JONES JR.
Title or Position: CEO
Credential: LCSW
Phone: 323-445-0303