Healthcare Provider Details

I. General information

NPI: 1205760030
Provider Name (Legal Business Name): TESSA DJIKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 50TH ST
SACRAMENTO CA
95817-2310
US

IV. Provider business mailing address

2501 54TH ST
SACRAMENTO CA
95817-1632
US

V. Phone/Fax

Practice location:
  • Phone: 916-703-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: