Provider Demographics
NPI:1508105297
Name:MUNOZ COHAN, JESSICA (LMFT)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:MUNOZ COHAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:SANCHEZ
Other - Last Name:MUNOZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MFTI
Mailing Address - Street 1:254 N LAKE AVE # 176
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1829
Mailing Address - Country:US
Mailing Address - Phone:626-901-2209
Mailing Address - Fax:
Practice Address - Street 1:254 N LAKE AVE # 176
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1829
Practice Address - Country:US
Practice Address - Phone:626-901-2209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFI79630106H00000X
CA106080106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist