Individual
JONATHAN PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
(310) 668-5902
Mailing address
1720 E 120TH ST, LOS ANGELES, CA 90059-3052
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
121641
IA
Other
Enumeration date
09/16/2016
Last updated
08/06/2023
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