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General NPI Number Information
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NPI Number | 1073308912
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Entity Type | Individual
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Provider Name | JESSICA ATMAJA
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Gender | Female
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 1051 S SUNKIST ST
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City | ANAHEIM
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State | CA
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Zip | 92806-5051
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Country | US
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Telephone | 714-517-8911
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Fax |
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Provider Business Mailing Address
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Address Line | 655 BAKER ST APT AA202
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City | COSTA MESA
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State | CA
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Zip | 92626-4495
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Country | US
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Telephone | 714-517-7500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | CA
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