Individual
MADELINE JESSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 MACARTHUR BLVD STE 600, EAST TOWER, NEWPORT BEACH, CA 92660-2517
(949) 432-9173
Mailing address
1854 W VALENCIA DR APT 8, FULLERTON, CA 92833-3200
(214) 789-9191
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
94029387
CA
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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