Basic Information
| Provider Information | |||||||||
| NPI: | 1629356324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHARLES-COMETA | ||||||||
| FirstName: | JAMILA | ||||||||
| MiddleName: | ATIYA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFT84390 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15336 DEVONSHIRE ST # 6 | ||||||||
| Address2: | |||||||||
| City: | MISSION HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913452755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3235380975 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11565 LAUREL CANYON BLVD # 1 | ||||||||
| Address2: | |||||||||
| City: | SAN FERNANDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913404168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183615030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2011 | ||||||||
| LastUpdateDate: | 04/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | LMFT84390 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.