Provider Demographics
NPI:1427243377
Name:BIANCHI, JESSICA BLAIR (BA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:BLAIR
Last Name:BIANCHI
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 1/2 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90026-2989
Mailing Address - Country:US
Mailing Address - Phone:480-430-0103
Mailing Address - Fax:
Practice Address - Street 1:10155 COLIMA RD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2063
Practice Address - Country:US
Practice Address - Phone:562-692-0383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist