MEDICARE: DR. JACQUELYN ASHLEY CORVAN HELMER PHD

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	103TC0700X	Clinical Psychologist	PSY28014	CA

General Provider Information

NPI Number	:	1255820221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELYN ASHLEY CORVAN HELMER PHD

Provider Business Mailing Address
First Line	:	5360 JACKSON DR STE 220-C
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-6002
Country	:	US
Telephone Number	:	619-439-8479
Fax Number	:	619-916-2457

Provider Business Practice Location Address
First Line	:	5360 JACKSON DR STE 220-C
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91942-6002
Country	:	US
Telephone Number	:	619-439-8479
Fax Number	:	619-916-2457

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

Provider Enumeration Date	:	05/05/2018
Last Update Date	:	03/24/2026

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