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General NPI Number Information
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NPI Number | 1568906428
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Entity Type | Individual
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Provider Name | JENNIFER CUMISKEY
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Gender | Female
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 1990 S BUNDY DR STE 100
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City | LOS ANGELES
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State | CA
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Zip | 90025-5255
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Country | US
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Telephone | 310-314-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 2175 FOOTHILL BLVD STE A
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City | LA VERNE
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State | CA
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Zip | 91750-2958
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 94497
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License Number State | CA
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