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Kassondra Jackie Sheppard
Mental Health Counselor in Santa Cruz, California
NPI 1407144926

Kassondra Jackie Sheppard is a Mental Health Counselor based in Santa Cruz, CA and is specialized in Mental Health. Kassondra Jackie Sheppard practices in Santa Cruz, CA. The NPI Number for Kassondra Jackie Sheppard is 1407144926 and holds a License No. (California).

The current practice location address for Kassondra Jackie Sheppard is 126 Front St, Santa Cruz, CA and can be reached out via phone at 831-427-9343.

Location: 126 Front St, Santa Cruz, CA, 95062-1663
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407144926
Provider Name
Kassondra Jackie Sheppard
Credential
Provider Entity Type
Individual
Gender
Female
Address
126 Front St, Santa Cruz, CA, 95062-1663
Phone Number
831-427-9343
Fax Number
Provider Enumeration Date
07/18/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MEDI-CAL PRV NBR 05 CA
44AV 01 CA FS RES MHSS
institution
Provider Business Practice Location Address Details
Address
126 Front St
City
Santa Cruz
State
California
Zip
95060-4402
Phone Number
831-427-9343
Fax Number
person
Provider Business Mailing Address Details
Address
126 Front St
City
Santa Cruz
State
California
Zip
95060-4402
Phone Number
831-427-9343
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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