Healthcare Provider Details

I. General information

NPI: 1346001906
Provider Name (Legal Business Name): JESSICA DELIA PARMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 AVENUE I STE 28
REDONDO BEACH CA
90277-5619
US

IV. Provider business mailing address

24325 CRENSHAW BLVD UNIT 1041
TORRANCE CA
90505-5349
US

V. Phone/Fax

Practice location:
  • Phone: 310-776-5989
  • Fax:
Mailing address:
  • Phone: 310-776-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number162904
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: