Healthcare Provider Details

I. General information

NPI: 1821910639
Provider Name (Legal Business Name): JESSICA COLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 W CARSON ST 202-186
TORRANCE CA
90501-2858
US

IV. Provider business mailing address

1820 W CARSON ST 202-186
TORRANCE CA
90501-2858
US

V. Phone/Fax

Practice location:
  • Phone: 818-738-7315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: