Provider Demographics
NPI:1457832735
Name:LERNER, JASON (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LERNER
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4759 MENDOTA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2234
Mailing Address - Country:US
Mailing Address - Phone:323-989-1975
Mailing Address - Fax:
Practice Address - Street 1:4759 MENDOTA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-2234
Practice Address - Country:US
Practice Address - Phone:323-989-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107575106H00000X
CA120164106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist