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Individual
MS. JILL LOUISE ANDERSON
Active
Individual
MS. JILL LOUISE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
31904
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/19/2008
Last updated
07/29/2020
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