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General NPI Number Information
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NPI Number | 1588329981
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Entity Type | Individual
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Provider Name | JIEXUAN LI LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 01/15/2022
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Provider Practice Location Address
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Address Line | 885 N SAN ANTONIO RD STE O
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City | LOS ALTOS
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State | CA
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Zip | 94022-1341
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Country | US
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Telephone | 650-434-2563
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Fax |
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Provider Business Mailing Address
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Address Line | 425 WASHINGTON BLVD APT 3002
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City | JERSEY CITY
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State | NJ
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Zip | 07310-2027
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Country | US
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Telephone | 646-298-2751
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 011279-01
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License Number State | NY
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