MEDICARE: JESSICA SCHULMAN EDELSTEIN LMFT, ATR, CDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	221700000X	Art Therapist	15-195	CA
2	106H00000X	Marriage & Family Therapist	93641	CA

General Provider Information

NPI Number	:	1104352590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SCHULMAN EDELSTEIN LMFT, ATR, CDP

Provider Business Mailing Address
First Line	:	5870 MELROSE AVE STE 3-399
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3756
Country	:	US
Telephone Number	:	424-634-1484
Fax Number	:

Provider Business Practice Location Address
First Line	:	5870 MELROSE AVE STE 3-399
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3756
Country	:	US
Telephone Number	:	424-634-1484
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	02/19/2022

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