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General NPI Number Information
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NPI Number | 1780719005
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Entity Type | Individual
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Provider Name | MRS. JENNIFER LYNN CHOKEMESIL
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 4030 PALOS VERDES DR N SUITE 106
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-2526
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Country | US
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Telephone | 310-808-3719
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 PALOS VERDES DR N SUITE 106
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City | ROLLING HILLS ESTATES
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State | CA
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Zip | 90274-1669
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Country | US
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Telephone | 310-658-1070
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 52898
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License Number State | CA
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