Healthcare Provider Details

I. General information

NPI: 1164189353
Provider Name (Legal Business Name): MARINDA LEE JESME M.ED., LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15635 ALTON PKWY STE 350
IRVINE CA
92618-7333
US

IV. Provider business mailing address

8201 CAPOBELLA
ALISO VIEJO CA
92656-1973
US

V. Phone/Fax

Practice location:
  • Phone: 929-528-6300
  • Fax:
Mailing address:
  • Phone: 218-280-0128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC13120
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC13120
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2607
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number909-8-1-17-422
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number909-8-1-17-422
License Number StateND
# 6
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC13120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: