Individual
MS. JESSICA MARIE GREENWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 N 14TH ST, SAN JOSE, CA 95112-6204
(510) 657-7409
Mailing address
25 N 14TH ST, SAN JOSE, CA 95112-6204
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
118241
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/21/2023
Last updated
01/26/2024
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