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NPI Code Detail

MEDICARE: MISS ERICA ELLEN JACOBSMA

MEDICARE: MISS ERICA ELLEN JACOBSMA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1437529930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ERICA ELLEN JACOBSMA
Provider Business Mailing Address
First Line : 2409 MERCED ST STE 106
Second Line :
City : FRESNO
State : CA
Zip : 93721-1829
Country : US
Telephone Number : 559-981-2795
Fax Number :
Provider Business Practice Location Address
First Line : 2409 MERCED ST STE 106
Second Line :
City : FRESNO
State : CA
Zip : 93721-1829
Country : US
Telephone Number : 559-981-2795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2015
Last Update Date : 09/28/2015

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Directions to “ MISS ERICA ELLEN JACOBSMA ” Practice Location

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