Provider Demographics
NPI:1366109803
Name:MOCH, JENA ALEXANDRA (ASW)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:ALEXANDRA
Last Name:MOCH
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11712 MOORPARK ST
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2154
Mailing Address - Country:US
Mailing Address - Phone:619-876-2494
Mailing Address - Fax:
Practice Address - Street 1:11712 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2154
Practice Address - Country:US
Practice Address - Phone:619-876-2494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker