Individual
MRS. JESSICA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 CUMMINS DR, MODESTO, CA 95358-6400
(209) 622-1420
Mailing address
4711 CROWS LANDING RD, MODESTO, CA 95358-9487
(209) 872-8078
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
ASW75435
CA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/28/2016
Last updated
01/17/2018
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