Provider Demographics
NPI:1912744723
Name:HOWARD, JESSICA LI MCCLAY (MSG, CMC, CDP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LI MCCLAY
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSG, CMC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 STANFORD ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3630
Mailing Address - Country:US
Mailing Address - Phone:310-963-6219
Mailing Address - Fax:310-496-2943
Practice Address - Street 1:1538 STANFORD ST APT 9
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3630
Practice Address - Country:US
Practice Address - Phone:310-963-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator