Healthcare Provider Details

I. General information

NPI: 1699931352
Provider Name (Legal Business Name): YESENIA CASAS-JACOBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 2ND ST
WOODLAND CA
95695-3316
US

IV. Provider business mailing address

PO BOX 980155
WEST SACRAMENTO CA
95798-0155
US

V. Phone/Fax

Practice location:
  • Phone: 530-312-4768
  • Fax: 530-297-8591
Mailing address:
  • Phone: 530-312-4768
  • Fax: 530-297-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83235
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: