Individual
JESSICA SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
3270 KERNER BLVD, SUITE A, SAN RAFAEL, CA 94901-4840
(415) 457-6964
Mailing address
241 REED ST, MILL VALLEY, CA 94941-4443
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
08/05/2024
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