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NPI Code Detail

MEDICARE: JESSICA MARIE MICHELI

MEDICARE: JESSICA MARIE MICHELI
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
1101YP2500XProfessional Counselor
2171M00000XCase Manager/Care Coordinator
3172V00000XCommunity Health WorkerCA
4225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1558788547
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIE MICHELI
Provider Business Mailing Address
First Line : 1795 GRAYBARK AVE
Second Line :
City : CLOVIS
State : CA
Zip : 93619-5031
Country : US
Telephone Number : 559-578-2411
Fax Number :
Provider Business Practice Location Address
First Line : 90 W ASHLAN AVE STE 100
Second Line :
City : CLOVIS
State : CA
Zip : 93612-5627
Country : US
Telephone Number : 559-882-5550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2014
Last Update Date : 07/08/2025

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