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General NPI Number Information
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NPI Number | 1447113287
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Entity Type | Individual
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Provider Name | JESSICA L R GORE AMFT #158919
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Gender | Female
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 11175 SAN PABLO AVE
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City | EL CERRITO
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State | CA
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Zip | 94530-2157
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Country | US
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Telephone | 510-559-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 2201 SHORELINE DR UNIT 1554
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City | ALAMEDA
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State | CA
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Zip | 94501-7339
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 158919
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License Number State | CA
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