Provider Demographics
NPI:1962831370
Name:NAUGHTON, JESSICA (PHD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NAUGHTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3363 LINDEN AVE
Mailing Address - Street 2:#C
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4579
Mailing Address - Country:US
Mailing Address - Phone:424-201-1600
Mailing Address - Fax:
Practice Address - Street 1:3363 LINDEN AVE
Practice Address - Street 2:#C
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4579
Practice Address - Country:US
Practice Address - Phone:424-201-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26039103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical