Provider Demographics
NPI:1366636219
Name:POSTIL, JESSICA ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANNE
Last Name:POSTIL
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 1:2222 MARTIN STE 170
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1450
Mailing Address - Country:US
Mailing Address - Phone:949-474-5577
Mailing Address - Fax:949-474-5575
Practice Address - Street 1:2222 MARTIN STE 170
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1450
Practice Address - Country:US
Practice Address - Phone:949-474-5577
Practice Address - Fax:949-474-5575
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200401114103K00000X
CA27251103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst