Individual
MS. ANN TODD JEALOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.F.T.
Contact information
Practice address
311 FOREST AVE, SUITE 2, PACIFIC GROVE, CA 93950-3367
(831) 644-9404
Mailing address
488 GIBSON AVE, PACIFIC GROVE, CA 93950-4416
(831) 644-9404
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC15923
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MFC15923
FAMILY THERAPIST
CA
Enumeration date
05/20/2007
Last updated
07/08/2007
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