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Individual

DR. JESSICA LEIGH THIVIERGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1501 5TH AVE, SAN DIEGO, CA 92101-3291
(619) 306-3225
Mailing address
1501 5TH AVE, SAN DIEGO, CA 92101-3291
(619) 306-3225

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
PSB94021710
CA

Other

Enumeration date
06/02/2008
Last updated
02/26/2016
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