MEDICARE: JESSICA COURTNEY FUNK LMFT

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	106H00000X	Marriage & Family Therapist	105709	CA

General Provider Information

NPI Number	:	1295008415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA COURTNEY FUNK LMFT

Provider Business Mailing Address
First Line	:	24020 ORLEANS LN
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-1937
Country	:	US
Telephone Number	:	951-279-3222
Fax Number	:

Provider Business Practice Location Address
First Line	:	24020 ORLEANS LN
Second Line	:
City	:	MURRIETA
State	:	CA
Zip	:	92562-1937
Country	:	US
Telephone Number	:	909-273-8127
Fax Number	:

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

Provider Enumeration Date	:	02/18/2012
Last Update Date	:	06/25/2026

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