Provider Demographics
NPI:1295318277
Name:ERFE, JESSICA MAE V (NONE)
Entity type:Individual
Prefix:MISS
First Name:JESSICA MAE
Middle Name:V
Last Name:ERFE
Suffix:
Gender:F
Credentials:NONE
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:ERFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NONE
Mailing Address - Street 1:8303 CLAIREMONT MESA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1326
Mailing Address - Country:US
Mailing Address - Phone:760-294-1206
Mailing Address - Fax:949-726-8324
Practice Address - Street 1:8303 CLAIREMONT MESA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1326
Practice Address - Country:US
Practice Address - Phone:760-294-1206
Practice Address - Fax:949-726-8324
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician