Individual
JESSICA LYNN DEATHERAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC TRAINEE
Contact information
Practice address
1275 HIGH ST, AUBURN, CA 95603-5016
(530) 264-8804
Mailing address
8740 GILARDI RD, NEWCASTLE, CA 95658-9341
(916) 617-9749
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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