Jennifer L Mitolo, Psy.D.
Psychologist, Clinical in Irvine, CA. Individual provider (NPI-1).
NPI number1861664088
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1861664088
- Entity type
- Individual (NPI-1)
- Name
- Jennifer L Mitolo
- Credential
- Psy.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2008
- Certification date
- Sep 16, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY25678 | CA | Yes |
| 103TC0700X | Psychologist, Clinical | 35SI00448400 | NJ |
Practice location
4040 Barranca Pkwy Ste 260Irvine, CA 92604-4780
Phone 925-282-1778 · Fax 415-296-5299
Mailing address
4040 Barranca Pkwy Ste 260Irvine, CA 92604-4780
Phone 925-282-1778 · Fax 415-296-5299
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