Provider Demographics
NPI:1699450841
Name:PIASECKI, JESSICA ANNE (AMFT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:PIASECKI
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 WEBSTER ST APT 655
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4642
Mailing Address - Country:US
Mailing Address - Phone:760-519-9809
Mailing Address - Fax:
Practice Address - Street 1:1100 WEBSTER ST APT 655
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4642
Practice Address - Country:US
Practice Address - Phone:760-519-9809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138653101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor