Provider Demographics
NPI:1326387952
Name:HOLZER, JESSICA (LMFT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HOLZER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9939 HIBERT ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1030
Mailing Address - Country:US
Mailing Address - Phone:858-284-4210
Mailing Address - Fax:
Practice Address - Street 1:9939 HIBERT ST STE 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1030
Practice Address - Country:US
Practice Address - Phone:858-284-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA91154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist