Provider Demographics
NPI:1558182006
Name:ROCHA-GARCIA, JESSICA CASSANDRA (LLMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CASSANDRA
Last Name:ROCHA-GARCIA
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:487 S DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-3236
Mailing Address - Country:US
Mailing Address - Phone:269-779-7577
Mailing Address - Fax:
Practice Address - Street 1:8145 VALLEYWOOD LN
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5296
Practice Address - Country:US
Practice Address - Phone:269-779-7577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511183921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty