Provider Demographics
NPI:1013499896
Name:HERRERA, JESSICA NOEMI
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NOEMI
Last Name:HERRERA
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 1:3117 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-5319
Mailing Address - Country:US
Mailing Address - Phone:661-324-4756
Mailing Address - Fax:661-617-2099
Practice Address - Street 1:3117 WILSON RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-5319
Practice Address - Country:US
Practice Address - Phone:661-324-4756
Practice Address - Fax:661-617-2099
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW836531041C0700X
CALCSW1070521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical