Healthcare Provider Details

I. General information

NPI: 1437752052
Provider Name (Legal Business Name): MRS. JESSIKA LENETT POWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JESSIKA LENETT BROWNING

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 W MAIN ST
MERCED CA
95340
US

IV. Provider business mailing address

642 W MAIN ST
MERCED CA
95340-4718
US

V. Phone/Fax

Practice location:
  • Phone: 209-205-1058
  • Fax: 209-205-1062
Mailing address:
  • Phone: 209-205-1058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: