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General NPI Number Information
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NPI Number | 1801556063
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Entity Type | Organization
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Legal Business Name | JUNGLEMANIA FAMILY SUPPORT
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 12501 PHILADELPHIA ST
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City | WHITTIER
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State | CA
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Zip | 90601-3900
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Country | US
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Telephone | 562-567-7417
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Fax |
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Provider Business Mailing Address
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Address Line | 11721 WHITTIER BLVD # 149
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City | WHITTIER
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State | CA
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Zip | 90601-3939
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Country | US
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Telephone | 562-567-7417
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JESSICA PEREZ
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Credential | LCSW
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Telephone | 562-567-7417
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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