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General NPI Number Information
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NPI Number | 1871898064
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Entity Type | Individual
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Provider Name | JIHAN VICTORIA JUDEH M.S.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 2555 E COLORADO BLVD # 101
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City | PASADENA
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State | CA
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Zip | 91107-6622
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Country | US
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Telephone | 562-999-6539
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Fax |
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Provider Business Mailing Address
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Address Line | 5505 E SANTA ANA CANYON RD UNIT 18921
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City | ANAHEIM
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State | CA
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Zip | 92817-1290
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Country | US
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Telephone | 562-999-6539
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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 | LMFT51292
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License Number State | CA
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