Healthcare Provider Details

I. General information

NPI: 1780500520
Provider Name (Legal Business Name): JESSICA LASATER, LICENSED PSYCHOLOGIST, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25350 MAGIC MOUNTAIN PKWY STE 300
VALENCIA CA
91355-1356
US

IV. Provider business mailing address

25350 MAGIC MOUNTAIN PKWY STE 300
VALENCIA CA
91355-1356
US

V. Phone/Fax

Practice location:
  • Phone: 818-917-5788
  • Fax:
Mailing address:
  • Phone: 818-917-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA R LASATER
Title or Position: PRESIDENT/CHIEF EXECUTIVE OFFICER
Credential: PSY.D
Phone: 818-917-5788