Individual
DR. ANDREW JEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
11925 WILSHIRE BLVD, 3RD FLOOR, LOS ANGELES, CA 90025-6618
(310) 453-2772
(310) 453-3833
Mailing address
11925 WILSHIRE BLVD, 3RD FLOOR, LOS ANGELES, CA 90025-6618
(310) 453-2772
(310) 453-3833
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY19185
CA
103TC0700X
Clinical Psychologist
Primary
PSY19185
CA
103TF0200X
Forensic Psychologist
PSY19185
CA
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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