MEDICARE: MRS. JESSICA ELIZABETH FARBER PSY.D.

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	103T00000X	Psychologist	PSY 22360	CA

General Provider Information

NPI Number	:	1366659047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA ELIZABETH FARBER PSY.D.

Provider Business Mailing Address
First Line	:	3880 S BASCOM AVE
Second Line	:	SUITE 202
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2674
Country	:	US
Telephone Number	:	408-800-2836
Fax Number	:	408-371-9193

Provider Business Practice Location Address
First Line	:	3880 S BASCOM AVE STE 111
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2600
Country	:	US
Telephone Number	:	408-800-2836
Fax Number	:	408-371-9193

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	11/26/2019

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