Healthcare Provider Details

I. General information

NPI: 1992638456
Provider Name (Legal Business Name): JESSE CLAYTON MCCOVEY SR. PEER SUPPORT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 AIRPORT RD
HOOPA CA
95546-9765
US

IV. Provider business mailing address

515 AIRPORT RD
HOOPA CA
95546-9765
US

V. Phone/Fax

Practice location:
  • Phone: 530-625-4261
  • Fax: 866-498-7125
Mailing address:
  • Phone: 707-298-4006
  • Fax: 866-498-7125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: