Individual ProviderMikkela Jazzmine EmeryMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3756 Santa Rosalia Dr Ste 219, Los Angeles, CA 90008-3616(323) 291-0191PECOS EnrollmentBased on the most recent information from CMS, provider Mikkela Jazzmine Emery does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1649645607Provider TypeIndividualFull NameEmery, Mikkela JazzmineGenderFemaleSole ProprietorNoEnumeration Date12/2/2015Last Updated8/5/2024Contact InformationPractice LocationPractice Address3756 Santa Rosalia Dr Ste 219, Los Angeles, CA 90008-3616Phone(323) 291-0191FaxUnlisted FaxMailing LocationMailing Address3756 Santa Rosalia Dr Ste 219, Los Angeles, CA 90008-3616Phone(323) 291-0191FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer