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NPI Code Detail

MEDICARE: JESSICA L HESS PH.D.

MEDICARE:   JESSICA L HESS  PH.D.
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
1103TC0700XClinical PsychologistPSY21552CA

General Provider Information

NPI Number : 1780724179
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L HESS PH.D.
Provider Business Mailing Address
First Line : 1137 HUNTINGTON DR STE A2
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-4580
Country : US
Telephone Number : 323-344-0123
Fax Number : 323-344-0132
Provider Business Practice Location Address
First Line : 1137 HUNTINGTON DR STE A2
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-4580
Country : US
Telephone Number : 323-344-0123
Fax Number : 323-344-0132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 04/17/2009

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