Provider Demographics
NPI:1235382284
Name:RICHARDS, JESSICA S (MS, MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS, MSW
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:S
Other - Last Name:DANKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 N MARENGO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4550
Mailing Address - Country:US
Mailing Address - Phone:626-765-1335
Mailing Address - Fax:
Practice Address - Street 1:95 N MARENGO AVE STE 100
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4550
Practice Address - Country:US
Practice Address - Phone:626-765-1335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273791041C0700X
CAASW24946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health