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General NPI Number Information
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NPI Number | 1295264505
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Entity Type | Organization
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Legal Business Name | MARY JESKO & ASSOCIATES
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11622 EL CAMINO REAL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2051
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Country | US
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Telephone | 858-597-7590
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Fax | 858-597-7490
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Provider Business Mailing Address
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Address Line | 11622 EL CAMINO REAL STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92130-2051
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Country | US
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Telephone | 858-597-7590
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Fax | 858-597-7490
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY ELLEN JESKO
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Credential | MS, ED.D
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Telephone | 858-597-7590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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