Provider Demographics
NPI:1598258741
Name:JEDRZEJEWSKI TOVAR, MEAGHAN MARIANNA (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:MEAGHAN
Middle Name:MARIANNA
Last Name:JEDRZEJEWSKI TOVAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:MEAGHAN
Other - Middle Name:MARIANNA
Other - Last Name:JEDRZEJEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3200 MOTOR AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-3740
Mailing Address - Country:US
Mailing Address - Phone:310-836-1223
Mailing Address - Fax:
Practice Address - Street 1:3200 MOTOR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-3740
Practice Address - Country:US
Practice Address - Phone:310-836-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent