Individual
JESIE MARIE AMAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 S VERMONT AVE FL 20, LOS ANGELES, CA 90020-1912
(213) 738-4775
(213) 947-1609
Mailing address
510 S VERMONT AVE FL 20, LOS ANGELES, CA 90020-1912
(213) 738-4775
(213) 947-1609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1494900123
CA
172V00000X
Community Health Worker
—
CA
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
05/08/2025
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