Individual
MR. CARL FREDERICK JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.A.S.
Contact information
Practice address
500 CROWN POINT CIR, GRASS VALLEY, CA 95945-9561
(530) 470-2759
Mailing address
13419 MCKITRICK RANCH RD, NEVADA CITY, CA 95959-9740
(530) 277-8809
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1824
C.A.S.
CA
Enumeration date
03/14/2007
Last updated
04/02/2025
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