Healthcare Provider Details

I. General information

NPI: 1740130673
Provider Name (Legal Business Name): JESSICA SCHWANKE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6620 WENTWORTH SPRINGS RD
GEORGETOWN CA
95634-9701
US

IV. Provider business mailing address

4501 ACORN RANCH RD
GARDEN VALLEY CA
95633-9478
US

V. Phone/Fax

Practice location:
  • Phone: 530-333-8340
  • Fax:
Mailing address:
  • Phone: 808-936-6884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCSW3977
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: