Healthcare Provider Details

I. General information

NPI: 1023989035
Provider Name (Legal Business Name): JAYBIRD WELLNESS GROUP, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23670 HAWTHORNE BLVD STE 210
TORRANCE CA
90505-8207
US

IV. Provider business mailing address

23670 HAWTHORNE BLVD STE 210
TORRANCE CA
90505-8207
US

V. Phone/Fax

Practice location:
  • Phone: 310-499-8727
  • Fax:
Mailing address:
  • Phone: 310-896-4470
  • Fax: 310-602-6537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JULIA R BAIRD
Title or Position: CEO
Credential: PSY.D.
Phone: 310-499-8727