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NPI Code Detail

MEDICARE: MS. JESSICA I WILKINS MS

MEDICARE:  MS. JESSICA I WILKINS  MS
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
1106H00000XMarriage & Family TherapistMFC35380CA

General Provider Information

NPI Number : 1194851360
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA I WILKINS MS
Provider Business Mailing Address
First Line : 1433 S ROBERTSON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90035-3414
Country : US
Telephone Number : 310-785-2121
Fax Number :
Provider Business Practice Location Address
First Line : 1433 S ROBERTSON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90035-3414
Country : US
Telephone Number : 310-785-2121
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2007
Last Update Date : 07/08/2007

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Directions to “ MS. JESSICA I WILKINS MS” Practice Location

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