Provider Demographics
NPI:1770345712
Name:WU, JESSICA (MFT-I)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 PLUMAS ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-6076
Mailing Address - Country:US
Mailing Address - Phone:775-786-6880
Mailing Address - Fax:775-786-6899
Practice Address - Street 1:6110 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6076
Practice Address - Country:US
Practice Address - Phone:775-786-6880
Practice Address - Fax:775-786-6899
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVM14285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist