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Individual

JESSIEKA MATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M. A., M.S., P.P.S.

Contact information

Practice address
5284 ALDOLFO RD., CAMARILLO, CA 93012
(805) 289-0128
(805) 289-0130
Mailing address
5284 ALDOLFO RD., CAMARILLO, CA 93012
(805) 289-0128
(805) 289-0130

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
56CC
ASPIRA
CA
Enumeration date
12/08/2014
Last updated
12/08/2014
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