Provider Demographics
NPI:1144077371
Name:GARCIA, JESSIKA MICHELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JESSIKA
Middle Name:MICHELLE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JESSIKA
Other - Middle Name:MICHELEE
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:1442A WALNUT ST # 456
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1405
Mailing Address - Country:US
Mailing Address - Phone:510-816-9126
Mailing Address - Fax:
Practice Address - Street 1:6031 IDAHO ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-2325
Practice Address - Country:US
Practice Address - Phone:510-253-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1213841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical