Provider Demographics
NPI:1023312261
Name:MCELROY, JESSICA RACHEL LYNN
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RACHEL LYNN
Last Name:MCELROY
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 1:1340 STILLMAN AVE
Mailing Address - Street 2:APARTMENT 28
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4009
Mailing Address - Country:US
Mailing Address - Phone:951-454-5427
Mailing Address - Fax:
Practice Address - Street 1:1340 STILLMAN AVE
Practice Address - Street 2:APARTMENT 28
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4009
Practice Address - Country:US
Practice Address - Phone:951-454-5427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical