Provider Demographics
NPI:1932077088
Name:ELIZABETH JEMIELITA MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:ELIZABETH JEMIELITA MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JEMIELITA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-493-2960
Mailing Address - Street 1:657 31ST ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3419
Mailing Address - Country:US
Mailing Address - Phone:323-493-2960
Mailing Address - Fax:
Practice Address - Street 1:3848 W CARSON ST STE 115
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6704
Practice Address - Country:US
Practice Address - Phone:323-493-2960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-28
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty