MEDICARE: JESSICA HERRERA

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	1041C0700X	Clinical Social Worker	PO19055	NC

General Provider Information

NPI Number	:	1780369215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HERRERA

Provider Business Mailing Address
First Line	:	1001 LITTLE JOHN TRL
Second Line	:
City	:	KANNAPOLIS
State	:	NC
Zip	:	28081-5762
Country	:	US
Telephone Number	:	980-250-3538
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 VINEHAVEN DR NE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2439
Country	:	US
Telephone Number	:	704-918-1343
Fax Number	:

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

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	03/20/2026

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Directions to “ JESSICA HERRERA ” Practice Location

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