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Jessica Lee Daniels

Marriage & Family Therapist

Behavioral Health & Social Service Providers

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Lee Daniels does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1235778150
Provider Type
Individual
Full Name
Daniels, Jessica Lee
Credential
AMFT

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/23/2019
Last Updated
10/2/2024

Contact Information

Practice Location

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

(323) 751-3026

Unlisted Fax

Mailing Location

3850 Crenshaw Blvd, Los Angeles, CA 90008-1821

(323) 751-3026

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 150065 California
Code 171M00000X	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License AMFT108689 California
Code 101YA0400X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Jessica Lee Daniels

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Mcdaniels, Keayera

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