Organization
JESSE WADE THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE WADE PSYD (PRESIDENT)
(916) 616-4504
Entity
Organization
Contact information
Practice address
2001 N ST STE 100, SACRAMENTO, CA 95811-4237
(916) 616-4505
Mailing address
2001 N ST STE 100, SACRAMENTO, CA 95811-4237
(916) 616-4505
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194159897
OTHER AGENCY
CA
Enumeration date
02/22/2022
Last updated
02/22/2022
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