Individual
JASSICA W JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 KINSER RD, CERES, CA 95307-7291
(120) 940-9082
Mailing address
1413 KINSER RD, CERES, CA 95307-7291
(209) 409-0825
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/15/2022
Last updated
11/29/2023
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