MEDICARE: MRS. JASEY ROSE STETSER MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	10819	CA

General Provider Information

NPI Number	:	1255036836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JASEY ROSE STETSER MA

Provider Business Mailing Address
First Line	:	191 LIGHTHOUSE AVE STE A5
Second Line	:
City	:	MONTEREY
State	:	CA
Zip	:	93940-1704
Country	:	US
Telephone Number	:	831-737-8295
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 E TAYLOR ST APT 2212
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95112-3149
Country	:	US
Telephone Number	:	408-796-2140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	01/09/2024

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