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General NPI Number Information
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NPI Number | 1780500520
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Entity Type | Organization
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Legal Business Name | JESSICA LASATER, LICENSED PSYCHOLOGIST, A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 23948 RUSTICO CT
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City | SANTA CLARITA
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State | CA
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Zip | 91354-1559
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Country | US
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Telephone | 818-917-5788
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Fax |
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Provider Business Mailing Address
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Address Line | 23055 SHERMAN WAY UNIT 4395
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City | WEST HILLS
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State | CA
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Zip | 91308-7024
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Country | US
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Telephone | 818-917-5788
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CHIEF EXECUTIVE OFFICER
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Name | JESSICA R LASATER
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Credential | PSY.D
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Telephone | 818-917-5788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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