Provider Demographics
NPI:1962051037
Name:ZIEHL, JESSICA (LMFT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ZIEHL
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 1:1072 CASITAS PASS RD # 245
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-2109
Mailing Address - Country:US
Mailing Address - Phone:323-821-8000
Mailing Address - Fax:
Practice Address - Street 1:30101 AGOURA CT STE 150
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4369
Practice Address - Country:US
Practice Address - Phone:323-821-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128896106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist