Provider Demographics
NPI:1093322810
Name:YAFFA, JESSICA (CPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:YAFFA
Suffix:
Gender:F
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 GARDENIA GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-7901
Mailing Address - Country:US
Mailing Address - Phone:858-413-6063
Mailing Address - Fax:
Practice Address - Street 1:630 GARDENIA GLN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-7901
Practice Address - Country:US
Practice Address - Phone:858-413-6063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor