Jessica Acock Carlisle
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Berkeley, CA
NPI 1073099479 · NPPES record last updated Jul 18, 2018
Key facts
- NPI
- 1073099479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 2222 Bancroft Way SPC 4300
Berkeley, CA 94720-4300 - Phone
- (510) 642-2367
- NPI assigned
- Jul 18, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
2222 Bancroft Way SPC 4300
Berkeley, CA 94720-4300
Mailing address
1219B Kirkham St
San Francisco, CA 94122-3420
Other providers in Berkeley, CA
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- Elle Abundis
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- Kristal Acosta
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- Thomas C Adame
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All providers in Berkeley, CA · Student in an Organized Health Care Education/Training Program in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2018. 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.