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NPI Code Detail

MEDICARE: JESSICA CARTER

MEDICARE: JESSICA CARTER
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
1104100000XSocial Worker25724CA

General Provider Information

NPI Number : 1164550174
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA CARTER
Provider Business Mailing Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2371
Fax Number :
Provider Business Practice Location Address
First Line : 3555 AUBURN BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-2005
Country : US
Telephone Number : 916-482-2371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 09/12/2011

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Directions to “ JESSICA CARTER ” Practice Location

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