Provider Demographics
NPI:1376318535
Name:JONEL MIZERAK MARRIAGE AND FAMILY THERAPIST PROFESSIONAL ORG
Entity Type:Organization
Organization Name:JONEL MIZERAK MARRIAGE AND FAMILY THERAPIST PROFESSIONAL ORG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JONEL
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MIZERAK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:925-548-8841
Mailing Address - Street 1:1610 OAK PARK BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4400
Mailing Address - Country:US
Mailing Address - Phone:925-548-8841
Mailing Address - Fax:
Practice Address - Street 1:1610 OAK PARK BLVD STE 208
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4400
Practice Address - Country:US
Practice Address - Phone:925-548-8841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty