Provider Demographics
NPI:1770344053
Name:PEACE-REDD, JILLIAN ALEXIS (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:ALEXIS
Last Name:PEACE-REDD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 N RIVERSIDE AVE STE C.182
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92377-4685
Mailing Address - Country:US
Mailing Address - Phone:909-278-2590
Mailing Address - Fax:
Practice Address - Street 1:675 W FOOTHILL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3475
Practice Address - Country:US
Practice Address - Phone:909-278-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14411106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist