Healthcare Provider Details

I. General information

NPI: 1720242548
Provider Name (Legal Business Name): JESSAMY REBECCA CADIGAN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. JESSAMY CADIGAN LAKENAN

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N DELAWARE ST
SAN MATEO CA
94401-1732
US

IV. Provider business mailing address

650 N DELAWARE ST
SAN MATEO CA
94401-1732
US

V. Phone/Fax

Practice location:
  • Phone: 650-558-2264
  • Fax:
Mailing address:
  • Phone: 650-558-2264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY29843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: