Individual
MR. JEREMY SCOTT BARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(263) 957-1006
Mailing address
840 N AVENUE 66, LOS ANGELES, CA 90042-1508
(626) 395-7100
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT36324
CA
Other
Enumeration date
08/08/2013
Last updated
08/01/2025
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