Provider Demographics
NPI:1972061018
Name:KAUFFMAN, JESSICA LOUISE
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LOUISE
Last Name:KAUFFMAN
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 1:1730 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6214
Mailing Address - Country:US
Mailing Address - Phone:559-825-8455
Mailing Address - Fax:
Practice Address - Street 1:1730 W WALNUT AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6214
Practice Address - Country:US
Practice Address - Phone:559-825-8455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst