Jamie Gordon

NPI #1194915652 in Venice, California

Provider Information

NPI Number: 1194915652
Entity Type: Individual
Name: Jamie Gordon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Jul 30, 2007
Last Updated: Jul 30, 2007

Practice Location

Address: 204 HAMPTON DR
City: Venice
State: California
ZIP Code: 90291-2623
Phone: (310) 399-6878

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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