Jessica Clark Therapy Services, Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

JESSICA CLARK THERAPY SERVICES, INC

Practice address

1101 Dianthus LN # 1101
El Dorado Hills, CA 95762-6817

Phone

(530) 461-5353

NPI assigned

Jun 2, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica Clark, LCSW

Title

Ceo/Director/Owner

Phone

(530) 461-5353

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1124694773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 DIANTHUS LN # 1101",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626817",
            "telephone_number": "530-461-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DIANTHUS LN # 1101",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626817",
            "telephone_number": "530-461-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA CLARK THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO/DIRECTOR/OWNER",
        "authorized_official_telephone_number": "530-461-5353",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ann Elizabeth Jeppesen, MPT
• Amy Johnson, LCSW
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• Crystal Johnson
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• Jennifer Ann Johnson, RDHAP

• Adult Mental Health Clinic/Center in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.