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General NPI Number Information
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NPI Number | 1184950495
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Entity Type | Individual
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Provider Name | JESSICA POLK BERKOWITZ HUNT LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 100 CONIFER LN
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2616
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Country | US
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Telephone | 925-708-6513
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CONIFER LN
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2616
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Country | US
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Telephone | 925-708-6513
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 079589-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33010
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 68936
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License Number State | CA
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