MEDICARE: JERELL PARKER

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	106H00000X	Marriage & Family Therapist	161573	CA

General Provider Information

NPI Number	:	1881546612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERELL PARKER

Provider Business Mailing Address
First Line	:	2163 ALDENGATE WAY UNIT 326
Second Line	:
City	:	HAYWARD
State	:	CA
Zip	:	94557-1007
Country	:	US
Telephone Number	:	510-994-8410
Fax Number	:

Provider Business Practice Location Address
First Line	:	545 ESTUDILLO AVE
Second Line	:
City	:	SAN LEANDRO
State	:	CA
Zip	:	94577-4611
Country	:	US
Telephone Number	:	510-459-7264
Fax Number	:

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

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	03/06/2026

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Directions to “ JERELL PARKER ” Practice Location

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