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General NPI Number Information
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NPI Number | 1356893135
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Entity Type | Individual
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Provider Name | JESSICA LILLIAN ZOVAR M.A.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 711 41ST AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95062-5208
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Country | US
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Telephone | 310-428-8689
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1870
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City | WATSONVILLE
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State | CA
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Zip | 95077-1870
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Country | US
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Telephone | 831-728-0222
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Fax | 831-707-2777
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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 | LMFT111742
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License Number State | CA
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