Healthcare Provider Details

I. General information

NPI: 1528270105
Provider Name (Legal Business Name): JEAN LOUISE TRESCOTT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD SUITE 360
MIAMI FL
33140-2800
US

IV. Provider business mailing address

1044 S NORTHLAKE DR
HOLLYWOOD FL
33019-1315
US

V. Phone/Fax

Practice location:
  • Phone: 305-772-0924
  • Fax: 954-920-0951
Mailing address:
  • Phone: 305-772-0924
  • Fax: 954-920-0951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPY4780
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY4780
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY4780
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPY4780
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPY4780
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License NumberPY4780
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: