Healthcare Provider Details

I. General information

NPI: 1417899659
Provider Name (Legal Business Name): JT INTEGRATIVE THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 N GARDNER ST APT 101
LOS ANGELES CA
90046-4151
US

IV. Provider business mailing address

1330 N GARDNER ST APT 101
LOS ANGELES CA
90046-4151
US

V. Phone/Fax

Practice location:
  • Phone: 714-392-0978
  • Fax:
Mailing address:
  • Phone: 714-392-0978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEREMY ERIC THULEMEYER
Title or Position: OWNER
Credential: LMFT
Phone: 714-392-0978