Provider Demographics
NPI:1093494544
Name:TESSIER, JILLIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:TESSIER
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 1:100 SHORELINE HWY
Mailing Address - Street 2:BUILDING B, SUITE 100
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941
Mailing Address - Country:US
Mailing Address - Phone:415-877-4408
Mailing Address - Fax:
Practice Address - Street 1:100 SHORELINE HWY
Practice Address - Street 2:BUILDING B, SUITE 100
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941
Practice Address - Country:US
Practice Address - Phone:415-877-4408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34187103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist