Provider Demographics
NPI:1720232382
Name:GIUNTA, JESSE
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:GIUNTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23801 CALABASAS RD STE 1025
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1585
Mailing Address - Country:US
Mailing Address - Phone:818-884-3122
Mailing Address - Fax:818-864-3231
Practice Address - Street 1:18321 VENTURA BLVD STE 515
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4248
Practice Address - Country:US
Practice Address - Phone:818-884-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45164106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist