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Organization
JOURNEY OF LIFE COUNSELING AND ASSESSMENT SERVICES
Active
Organization
JOURNEY OF LIFE COUNSELING AND ASSESSMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASEON OUTLAW PH.D. (CLINICAL DIRECTOR/OWNER)
(510) 463-1302
Entity
Organization
Contact information
Practice address
1068 E 14TH ST, SAN LEANDRO, CA 94577-3731
(510) 463-1302
Mailing address
1068 E 14TH ST, SAN LEANDRO, CA 94577-3731
(510) 463-1302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY23676
CA
106H00000X
Marriage & Family Therapist
53851
CA
Other
Enumeration date
01/09/2014
Last updated
01/09/2014
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