| Doctor Name: | JILL MARIE WUSSLER |
| NPI Number: | 1023372752 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 28490 |
| Business Practice Address: | 609 Deep Valley Dr Ste 200 Rolling Hills Estates, CA - 902743614 |
| Business Phone Number: | 3107676813 |
| Business Fax Number: | |
| Mailing Address: | 609 Deep Valley Dr Ste 200, ROLLING HILLS ESTATES |
| State: | CA |
| Postal Code: | 902743614 |
| Phone Number: | 3107676813 |
| Fax Number: | |
| NPI Enumeration Date: | 06/27/2012 |
| NPI Last Update Date: | 10/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 28490 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |