Provider Demographics
NPI:1639346372
Name:CLIFF, JESSICA BROOKE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:BROOKE
Last Name:CLIFF
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:BROOKE
Other - Last Name:SARTAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:2500 OLD CROW CANYON RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1623
Mailing Address - Country:US
Mailing Address - Phone:925-328-0186
Mailing Address - Fax:
Practice Address - Street 1:2500 OLD CROW CANYON RD
Practice Address - Street 2:SUITE 218
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1623
Practice Address - Country:US
Practice Address - Phone:925-328-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 45576106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist