Healthcare Provider Details

I. General information

NPI: 1619273224
Provider Name (Legal Business Name): JESSICA PLOTIN MA, LMFT, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 JOHNSON AVE
SAN LUIS OBISPO CA
93401-4131
US

IV. Provider business mailing address

3515 ATLANTIC AVE # 1160
LONG BEACH CA
90807-4515
US

V. Phone/Fax

Practice location:
  • Phone: 805-242-3102
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number79279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: