Healthcare Provider Details

I. General information

NPI: 1609730241
Provider Name (Legal Business Name): JESSICA TURNBULL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA PAXTON

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 GREEN VALLEY RD
PLACERVILLE CA
95667-8984
US

IV. Provider business mailing address

6767 GREEN VALLEY RD
PLACERVILLE CA
95667-8984
US

V. Phone/Fax

Practice location:
  • Phone: 530-295-8650
  • Fax:
Mailing address:
  • Phone: 530-295-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number084276BF7A
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: