Healthcare Provider Details

I. General information

NPI: 1821927559
Provider Name (Legal Business Name): JESSICA LYNN PUMPA APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BEL MARIN KEYS BLVD STE 215
NOVATO CA
94949-5798
US

IV. Provider business mailing address

907 BEL MARIN KEYS BLVD
NOVATO CA
94949-5331
US

V. Phone/Fax

Practice location:
  • Phone: 415-971-2364
  • Fax:
Mailing address:
  • Phone: 415-971-2364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC22396
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: