Healthcare Provider Details
I. General information
NPI: 1326975517
Provider Name (Legal Business Name): JESSLYN R SEPEDA CPSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/04/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1393 BAILEY ST
HANFORD CA
93230-5922
US
IV. Provider business mailing address
1393 BAILEY ST
HANFORD CA
93230-5922
US
V. Phone/Fax
- Phone: 559-582-4481
- Fax:
- Phone: 559-582-4481
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | MPSS-XCBLJE |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: