Provider Demographics
NPI:1881429694
Name:ZUSMAN, JENNA (PA)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ZUSMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7183 NAVAJO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119-1696
Mailing Address - Country:US
Mailing Address - Phone:949-677-3049
Mailing Address - Fax:
Practice Address - Street 1:7183 NAVAJO RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-1696
Practice Address - Country:US
Practice Address - Phone:949-677-3049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027005103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist