Provider Demographics
NPI:1750789509
Name:ADLER, JORI (MA, MFT)
Entity type:Individual
Prefix:
First Name:JORI
Middle Name:
Last Name:ADLER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:JORI
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:3848 LYCEUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4125
Mailing Address - Country:US
Mailing Address - Phone:310-569-3404
Mailing Address - Fax:
Practice Address - Street 1:3848 LYCEUM AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4125
Practice Address - Country:US
Practice Address - Phone:310-569-3404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84051106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist