Provider Demographics
NPI:1306537253
Name:ESTEPA, JEANNE NIKA DOLORES
Entity type:Individual
Prefix:MISS
First Name:JEANNE NIKA
Middle Name:DOLORES
Last Name:ESTEPA
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 1:1500 67TH ST. WEXLER
Mailing Address - Street 2:APT 1422
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-4368
Mailing Address - Country:US
Mailing Address - Phone:209-280-6101
Mailing Address - Fax:
Practice Address - Street 1:1500 67TH ST APT 1422
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-4368
Practice Address - Country:US
Practice Address - Phone:209-280-6101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst