Jessica Agricola

Individual provider Active NPI Clinical Social Worker · Placerville, CA

NPI 1689937542 · NPPES record last updated Jun 15, 2012

Key facts

NPI
1689937542
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
670 Placerville Dr
#1B
Placerville, CA 95667-4200
Phone
(530) 621-6344
NPI assigned
Jun 15, 2012
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

670 Placerville Dr
#1B
Placerville, CA 95667-4200

Mailing address

670 Placerville Dr
#1B
Placerville, CA 95667-4200
Phone (530) 621-6344

Other providers in Placerville, CA

All providers in Placerville, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.