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NPI Code Detail

MEDICARE: JESSICA PLOEG

MEDICARE: JESSICA PLOEG
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
1103K00000XBehavior Analyst1-16-24379CA

General Provider Information

NPI Number : 1578002838
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA PLOEG
Provider Business Mailing Address
First Line : 1900 EMBARCADERO STE 310
Second Line :
City : OAKLAND
State : CA
Zip : 94606-5227
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1900 EMBARCADERO STE 310
Second Line :
City : OAKLAND
State : CA
Zip : 94606-5227
Country : US
Telephone Number : 510-832-4383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2017
Last Update Date : 02/20/2017

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Directions to “ JESSICA PLOEG ” Practice Location

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