MEDICARE: JESSICA ANGELINE BELCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	063970324	CA

General Provider Information

NPI Number	:	1134398654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ANGELINE BELCHER

Provider Business Mailing Address
First Line	:	670 PLACERVILLE DR
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-4200
Country	:	US
Telephone Number	:	530-344-4843
Fax Number	:	530-622-5800

Provider Business Practice Location Address
First Line	:	670 PLACERVILLE DR
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-4200
Country	:	US
Telephone Number	:	530-295-1657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2008
Last Update Date	:	05/28/2026

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