Jessica Fletcher
Individual provider Active NPI Massage Therapist · Crestline, CA
NPI 1467115642 · NPPES record last updated Apr 12, 2022
Key facts
- NPI
- 1467115642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 81056 (CA)
- Practice address
- 628 Wildrose LN
Crestline, CA 92325-9379 - Phone
- (909) 654-7502
- NPI assigned
- Oct 15, 2021
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81056 | CA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | 81056 | CA | Yes |
Addresses
Primary practice location
628 Wildrose LN
Crestline, CA 92325-9379
Mailing address
PO Box 4012
Crestline, CA 92325-4012
Phone (909) 362-0738
Other providers in Crestline, CA
- Kevin Ewert
- Michael E Ewert
- Megan Fallis
- Family Service Agency of San Bernardino
- Monica Pauline Ferreri
- Kaleen Marie Foster
- Paul William Fournier
- Ginger Virginia Gabriel
- Diana Garcia
- Hannah Garcia
All providers in Crestline, CA · Massage Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2022. 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.