Provider Demographics
NPI:1548356033
Name:WELLS, JO ANN (RASI)
Entity type:Individual
Prefix:MS
First Name:JO ANN
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:RASI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 J STREET
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814
Mailing Address - Country:US
Mailing Address - Phone:916-325-5556
Mailing Address - Fax:916-440-5620
Practice Address - Street 1:1820 J STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814
Practice Address - Country:US
Practice Address - Phone:916-325-5556
Practice Address - Fax:916-440-5620
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA04000X101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)