Provider Demographics
NPI:1952434003
Name:MILSTEIN, JODI (MA)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:
Last Name:MILSTEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:
Other - Last Name:JACOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:13351-D RIVERSIDE DRIVE # 635
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2508
Mailing Address - Country:US
Mailing Address - Phone:310-678-8241
Mailing Address - Fax:
Practice Address - Street 1:15235 BURBANK BLVD., SUITE B2
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411
Practice Address - Country:US
Practice Address - Phone:818-623-7222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPC857101YP2500X
CAMFC45503106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional