Provider Demographics
NPI:1124849096
Name:MCGREGOR, JESSICA LEE (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:JAYLEE
Other - Middle Name:
Other - Last Name:MCGREGOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10166 VIRGIL CT
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-9154
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:673 S AUBURN ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7576
Practice Address - Country:US
Practice Address - Phone:530-913-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1264931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical