Jessica Eryn Aho, PSY.D.
Individual provider Active NPI Clinical Psychologist · Represa, CA
NPI 1760763585 · NPPES record last updated Jun 14, 2022
Key facts
- NPI
- 1760763585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY28662 (CA)
- Practice address
- 100 Prison Rd
Represa, CA 95671-0002 - Phone
- (916) 985-8610
- NPI assigned
- Sep 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| PSY28662 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | PSY28662 | CA | Yes |
Addresses
Primary practice location
100 Prison Rd
Represa, CA 95671-0002
Mailing address
PO Box 290002
Represa, CA 95671-0002
Phone (916) 985-8610
Other providers in Represa, CA
All providers in Represa, CA · Clinical Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 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.