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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952943342 | NPPES |
| California | Other | 01536011 | MEDI-CAL |
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