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General NPI Number Information
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NPI Number | 1477285526
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Entity Type | Individual
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Provider Name | JESSICA CINDAL NEVAREZ
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Gender | Female
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 13222 CHAPMAN AVE
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City | GARDEN GROVE
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State | CA
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Zip | 92840-4414
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Country | US
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Telephone | 855-588-1422
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Fax |
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Provider Business Mailing Address
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Address Line | 5675 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90036-4712
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Country | US
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Telephone | 323-965-1365
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Fax | 323-965-0444
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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 | AMFT142432
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License Number State | CA
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