Provider Demographics
NPI:1407630924
Name:FOSTER, JESSICA LOUISE
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LOUISE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5423
Mailing Address - Country:US
Mailing Address - Phone:415-905-0459
Mailing Address - Fax:
Practice Address - Street 1:1727 MARTIN LUTHER KING JR WAY STE 109
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1358
Practice Address - Country:US
Practice Address - Phone:510-893-9230
Practice Address - Fax:510-893-2074
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor