Jessica Freedman
Individual provider Active NPI Clinical Social Worker · Fortuna, CA
NPI 1013478023 · NPPES record last updated Mar 31, 2019
Key facts
- NPI
- 1013478023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 67134 (CA)
- Practice address
- 1100 Main St Ste B
Fortuna, CA 95540-2148 - Phone
- (707) 734-0896
- NPI assigned
- Mar 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67134 | CA | MD | Clinical Social Worker |
| 88503 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 67134 | CA | Yes |
Addresses
Primary practice location
1100 Main St Ste B
Fortuna, CA 95540-2148
Mailing address
1100 Main St Ste B
Fortuna, CA 95540-2148
Other providers in Fortuna, CA
- Fortuna Rehabilitation & Wellness Center, LP
- Fortuna Union High School
- Tatsiana Franco
- Maureen B Frank
- Joy Nadine Frasier
- Donald Vincent Fregeau Jr.
- Alan E French
- William M French
- Janna M Froeming
- Judy Gallagher
All providers in Fortuna, CA · Clinical Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.