Acosta, Jessica G

Acosta, Jessica G is an sole proprietor health care provider with primary practice located at 1625 Schrader Blvd , Los Angeles CA 90028-6213. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Acosta, Jessica G can be contacted via phone (323) 993-7477.

Contact Information

Primary practice address
1625 Schrader Blvd Los Angeles CA 90028-6213
Phone: (323) 993-7477
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1952943342
LBN Legal business name Acosta, Jessica G
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2019
Last updated Oct 17th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952943342 NPPES
California Other 01536011 MEDI-CAL

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