Provider Demographics
NPI:1215258926
Name:ROBB, JESSIE L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSIE
Middle Name:L
Last Name:ROBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1938 S CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6208
Mailing Address - Country:US
Mailing Address - Phone:559-284-0913
Mailing Address - Fax:
Practice Address - Street 1:334 SHAW AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3847
Practice Address - Country:US
Practice Address - Phone:559-454-1819
Practice Address - Fax:559-255-2930
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS139221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical