Provider Demographics
NPI:1477789410
Name:HIRSCHMAN, JILL K (LMFT)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:K
Last Name:HIRSCHMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:K
Other - Last Name:HIRSCHMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1 SPINNAKER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-7155
Mailing Address - Country:US
Mailing Address - Phone:310-836-7849
Mailing Address - Fax:310-821-2163
Practice Address - Street 1:4519 ADMIRALTY WAY
Practice Address - Street 2:#200
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5441
Practice Address - Country:US
Practice Address - Phone:310-836-7849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30852106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist