Healthcare Provider Details

I. General information

NPI: 1629200803
Provider Name (Legal Business Name): CHANA JESSICA CEASAR MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6573
ALBANY CA
94706-0573
US

IV. Provider business mailing address

PO BOX 6573
ALBANY CA
94706-0573
US

V. Phone/Fax

Practice location:
  • Phone: 415-496-6792
  • Fax:
Mailing address:
  • Phone: 415-496-6792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number87402
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number217
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: