Most Relevant Information
Provider Data
| NPI Number: | 1003491671 |
| Provider Name: | JACQUELYN KESSERMAN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCSW81103 |
Most Important Dates
| Enumeration Date: | 03/15/2021 |
| Last Updated: | 03/15/2021 |
Provider Practice Location
10350 MIRANDA AVE
BUENA PARK
CA
906204447
Practice Location Phone/Fax
| Phone: | 5627158703 |
| Fax: |
Provider Mailing Location
10350 MIRANDA AVE
BUENA PARK
CA
906204447
Provider Mailing Phone/Fax
| Phone: | 5627158703 |
| Fax: |