Provider Demographics
NPI:1568273183
Name:OUR COMMON HEART
Entity type:Organization
Organization Name:OUR COMMON HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JESSUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-880-0007
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-1027
Mailing Address - Country:US
Mailing Address - Phone:818-880-0250
Mailing Address - Fax:
Practice Address - Street 1:3198 GORGE RD
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-3518
Practice Address - Country:US
Practice Address - Phone:818-880-0250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty