Basic Information
| Provider Information | |||||||||
| NPI: | 1770961997 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRESS | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1632 141ST AVE | ||||||||
| Address2: | |||||||||
| City: | SAN LEANDRO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945781704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105769952 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1016 HOWARD ST | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941032807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152261775 | ||||||||
| FaxNumber: | 4159028753 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2015 | ||||||||
| LastUpdateDate: | 10/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | ASW65419 | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.