Provider Demographics
NPI:1871898064
Name:JUDEH, JIHAN VICTORIA (MS)
Entity type:Individual
Prefix:
First Name:JIHAN
Middle Name:VICTORIA
Last Name:JUDEH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 E SANTA ANA CANYON RD UNIT 18921
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-1290
Mailing Address - Country:US
Mailing Address - Phone:562-999-6539
Mailing Address - Fax:
Practice Address - Street 1:2555 E COLORADO BLVD # 101
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-6622
Practice Address - Country:US
Practice Address - Phone:562-999-6539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51292106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist