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Organization

BENEATH THE SURFACE THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JILLIAN COZETE ELLISON LMFT (FOUNDER AND CLINICAL DIRECTOR)
(760) 836-6292
Entity
Organization

Contact information

Practice address
78150 CALLE TAMPICO, STE 200I, LA QUINTA, CA 92253
(760) 836-6292
(760) 369-7352
Mailing address
78150 CALLE TAMPICO, STE 200I, LA QUINTA, CA 92253
(760) 836-6292
(760) 369-7352

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
07/26/2025
Last updated
07/28/2025
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