Jeremy Stephen Thacker
NPI #1508661794 in Studio City, California
Provider Information
- NPI Number
- 1508661794
- Entity Type
- Individual
- Name
- Jeremy Stephen Thacker
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Feb 13, 2025
- Last Updated
- Feb 13, 2025
Practice Location
- Address
- 11712 MOORPARK ST STE 204B
- City
- Studio City
- State
- California
- ZIP Code
- 91604-2158
- Phone
- (323) 834-2420
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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