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General NPI Number Information
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NPI Number | 1003345992
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH WILINSKI LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/06/2017
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 2085 RUSTIN AVE BLDG 4
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City | RIVERSIDE
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State | CA
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Zip | 92507-2498
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Country | US
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Telephone | 951-955-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 ALTURA DR
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City | RIVERSIDE
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State | CA
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Zip | 92507-2818
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Country | US
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Telephone | 818-536-9079
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 102038
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License Number State | CA
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