Healthcare Provider Details

I. General information

NPI: 1124509856
Provider Name (Legal Business Name): JESSICA NICOLE BAILEY-PIERRE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 CAMINO DIABLO STE 105
WALNUT CREEK CA
94597-3945
US

IV. Provider business mailing address

2960 CAMINO DIABLO STE 105
WALNUT CREEK CA
94597-3945
US

V. Phone/Fax

Practice location:
  • Phone: 800-892-2695
  • Fax:
Mailing address:
  • Phone: 800-892-2695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-10613
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW15441
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: