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NPI Code Detail

MEDICARE: JILLIAN ZIESMER

MEDICARE: JILLIAN ZIESMER
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
1101YP2500XProfessional Counselor7658CA

General Provider Information

NPI Number : 1790164994
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN ZIESMER
Provider Business Mailing Address
First Line : 9808 VENICE BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-2732
Country : US
Telephone Number : 310-945-3350
Fax Number : 310-945-3356
Provider Business Practice Location Address
First Line : 11835 W OLYMPIC BLVD STE 815E
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-5056
Country : US
Telephone Number : 310-428-7240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2015
Last Update Date : 04/13/2020

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Directions to “ JILLIAN ZIESMER ” Practice Location

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