Individual
JESSICA VIANNEY MOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1336 BRIDGEGATE DR FL 2, DIAMOND BAR, CA 91765-3955
(909) 781-4618
Mailing address
1336 BRIDGEGATE DR FL 2, DIAMOND BAR, CA 91765-3955
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2016
Last updated
12/13/2024
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