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NPI Code Detail

MEDICARE: MR. JESSE D TAMPLEN L.C.S.W.

MEDICARE: MR. JESSE D TAMPLEN L.C.S.W.
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
11041C0700XClinical Social Worker23398CA

General Provider Information

NPI Number : 1932348224
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JESSE D TAMPLEN L.C.S.W.
Provider Business Mailing Address
First Line : 1547 PALOS VERDES MALL
Second Line : PMB218
City : WALNUT CREEK
State : CA
Zip : 94597-2228
Country : US
Telephone Number : 510-725-2427
Fax Number :
Provider Business Practice Location Address
First Line : 1547 PALOS VERDES MALL
Second Line : PMB218
City : WALNUT CREEK
State : CA
Zip : 94597-2228
Country : US
Telephone Number : 510-725-2427
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2009
Last Update Date : 02/11/2009

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