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General NPI Number Information
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NPI Number | 1083223697
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Entity Type | Individual
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Provider Name | JESSICA AVIVAH ASKARI
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Gender | Female
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Dates
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Enumeration Date | 07/29/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 2101 ROSECRANS AVE STE 3270
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City | EL SEGUNDO
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State | CA
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Zip | 90245-4736
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Country | US
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Telephone | 626-899-0238
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1153
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-1153
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Country | US
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Telephone | 424-235-8905
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120514
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License Number State | CA
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