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General NPI Number Information
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NPI Number | 1164304242
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Entity Type | Individual
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Provider Name | JACEY JOHNSON PICKENS-JONES
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Gender | Female
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 900 FULTON AVE STE 160
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City | SACRAMENTO
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State | CA
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Zip | 95825-4517
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Country | US
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Telephone | 916-426-6567
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 TOPSAIL PL
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City | DAVIS
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State | CA
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Zip | 95616-2739
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Country | US
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Telephone | 510-213-4359
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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 | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State | CA
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