MEDICARE: JESSICA HASSANI M.ED, PPSC

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	101YS0200X	School Counselor	240244070	CA
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1568277382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HASSANI M.ED, PPSC

Provider Business Mailing Address
First Line	:	2700 PORTER ST
Second Line	:
City	:	SOQUEL
State	:	CA
Zip	:	95073-2498
Country	:	US
Telephone Number	:	831-464-5655
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 PORTER ST
Second Line	:
City	:	SOQUEL
State	:	CA
Zip	:	95073-2498
Country	:	US
Telephone Number	:	831-464-5655
Fax Number	:

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

Provider Enumeration Date	:	02/10/2025
Last Update Date	:	02/10/2025

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