Provider Demographics
NPI:1154502128
Name:TOVAR, JESSICA EDITH (ASW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:EDITH
Last Name:TOVAR
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N BROADWAY STE 212
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3404
Mailing Address - Country:US
Mailing Address - Phone:714-972-2610
Mailing Address - Fax:714-972-2620
Practice Address - Street 1:12440 FIRESTONE BLVD STE 3001
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4300
Practice Address - Country:US
Practice Address - Phone:866-869-6608
Practice Address - Fax:424-378-6329
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical