JADE STAR FEWELL

COSTA MESA, CA
NPI1780347237
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: CA  94026429)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  15155)
Enumeration Date2021-10-20
Last Update Date2021-12-26
Business Address
Dr. JADE STAR FEWELL Psy.D.Assistant
3151 AIRWAY AVE STE J2
COSTA MESA, CA 92626-4624
Phone number: 949-702-4677
Mailing Address
Dr. JADE STAR FEWELL Psy.D.Assistant
PO BOX 1946
LAGUNA BEACH, CA 92652-1946
Phone number: 949-702-4677