Provider Demographics
NPI:1538524673
Name:VALLUZZI, JESSICA A (PSYD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:A
Last Name:VALLUZZI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 WESTWOOD BLVD STE 400
Mailing Address - Street 2:MAILCODE: 738546
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2934
Mailing Address - Country:US
Mailing Address - Phone:310-267-1186
Mailing Address - Fax:
Practice Address - Street 1:924 WESTWOOD BLVD STE 400
Practice Address - Street 2:MAILCODE: 738546
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-2934
Practice Address - Country:US
Practice Address - Phone:310-267-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27687103TB0200X, 103TC0700X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy