Basic Information
| Provider Information | |||||||||
| NPI: | 1255004263 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAFF | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | JOY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9724 ERIN WAY APT 203 | ||||||||
| Address2: | |||||||||
| City: | SANTEE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920715281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7606258068 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4309 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921031407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6198764502 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2021 | ||||||||
| LastUpdateDate: | 10/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 101Y00000X | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.