Provider Demographics
NPI:1275760043
Name:JEFFREY, JESSICA KAY (MD, MPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:KAY
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S SHERBOURNE DR
Mailing Address - Street 2:8
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4028
Mailing Address - Country:US
Mailing Address - Phone:310-205-8942
Mailing Address - Fax:
Practice Address - Street 1:424 S SHERBOURNE DR
Practice Address - Street 2:8
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4028
Practice Address - Country:US
Practice Address - Phone:310-205-8942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CAA1160232084P0802X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry