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NPI Code Detail

MEDICARE: JESSICA MUELLER MA

MEDICARE: JESSICA MUELLER MA
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
1103TC0700XClinical PsychologistCA30498CA
2103TF0200XForensic PsychologistCA

General Provider Information

NPI Number : 1952750697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MUELLER MA
Provider Business Mailing Address
First Line : 3555 ROSECRANS ST STE 114
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3232
Country : US
Telephone Number : 831-200-3444
Fax Number :
Provider Business Practice Location Address
First Line : 11526 SORRENTO VALLEY RD STE A2
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1314
Country : US
Telephone Number : 831-200-3444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2016
Last Update Date : 11/17/2025

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