Provider Demographics
NPI:1508193673
Name:BEAUCHENE, JESSICA (MD)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:BEAUCHENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 UNIVERSITY AVE
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6531
Mailing Address - Country:US
Mailing Address - Phone:916-565-7641
Mailing Address - Fax:
Practice Address - Street 1:333 UNIVERSITY AVE
Practice Address - Street 2:SUITE #200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6531
Practice Address - Country:US
Practice Address - Phone:916-565-7641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1229992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry