Provider Demographics
NPI:1437752052
Name:POWELL, JESSIKA LENETT
Entity Type:Individual
Prefix:MRS
First Name:JESSIKA
Middle Name:LENETT
Last Name:POWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JESSIKA
Other - Middle Name:LENETT
Other - Last Name:BROWNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10850 GOLD CENTER DRIVE
Mailing Address - Street 2:SUITE 325
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670
Mailing Address - Country:US
Mailing Address - Phone:916-364-8395
Mailing Address - Fax:916-364-8395
Practice Address - Street 1:1803 W. MARCH LN
Practice Address - Street 2:SUITE C
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207
Practice Address - Country:US
Practice Address - Phone:209-636-5353
Practice Address - Fax:209-636-5354
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No104100000XBehavioral Health & Social Service ProvidersSocial Worker