Provider Demographics
NPI:1346001906
Name:PARMAR, JESSICA DELIA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:DELIA
Last Name:PARMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21535 HAWTHORNE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6626
Mailing Address - Country:US
Mailing Address - Phone:310-817-2177
Mailing Address - Fax:
Practice Address - Street 1:21535 HAWTHORNE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6626
Practice Address - Country:US
Practice Address - Phone:310-817-2177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT143291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist