Jessica Barraza, DR

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

261QM2800X Issued in WI

Practice address

342 S Michiels Rd
Green Bay, WI 54311-9569

Phone

(937) 980-6480

NPI assigned

Mar 25, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Van Brocklin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1831037142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31626 N ROY ROGERS TRL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851446200",
            "telephone_number": "937-980-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 S MICHIELS RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543119569",
            "telephone_number": "937-980-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAZA",
        "first_name": "JESSICA",
        "credential": "DR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "261QM2800X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VAN BROCKLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabe Mathew Barnes, PHARMD
• Gregory Patrick Barnes, RPH
• Suzanne H Barnes, DO
• Alexander C Barr, MD
• Grace Abigaille Barranco-Laxamana
• Maria Theresa Barrera Gutierrez, LCSW
• Rebecca Marie Barrett, MSW APSW
• Kris L Barrette, APNP
• Elyssa Barrow, PA-C
• Kristin S Barrows, RDH

• Cognitive & Behavioral Psychologist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Cognitive & Behavioral Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.