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General NPI Number Information
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NPI Number | 1780487736
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Entity Type | Individual
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Provider Name | JESSICA NICOLE HIDALGO
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Gender | Female
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Dates
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Enumeration Date | 03/27/2025
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 1321 HOWE AVE STE 113
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City | SACRAMENTO
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State | CA
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Zip | 95825-3365
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Country | US
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Telephone | 916-272-1920
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Fax |
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Provider Business Mailing Address
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Address Line | 10201 BLOSSOM RIDGE DR
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City | ELK GROVE
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State | CA
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Zip | 95757-2520
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Country | US
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Telephone | 916-704-0644
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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 | APCC18654
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License Number State | CA
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