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Miss Jessica Briana Sample
Mental Health Counselor in Pomona, California
NPI 1932758869

Jessica Briana Sample is a Mental Health Counselor based in Pomona, CA and is specialized in Mental Health. Jessica Briana Sample practices in Pomona, CA. The NPI Number for Jessica Briana Sample is 1932758869 and holds a License No. 19-155 (California).

The current practice location address for Jessica Briana Sample is 1050 N Garey Ave, Pomona, CA and can be reached out via phone at 909-623-6391 and via fax at 909-620-9491.

Location: 1050 N Garey Ave, Pomona, CA, 91767-3802
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932758869
Provider Name
Jessica Briana Sample
Credential
Provider Entity Type
Individual
Gender
Female
Address
1050 N Garey Ave, Pomona, CA, 91767-3802
Phone Number
909-623-6391
Fax Number
909-620-9491
Provider Enumeration Date
09/04/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1023173135 05 CA
institution
Provider Business Practice Location Address Details
Address
1050 N Garey Ave
City
Pomona
State
California
Zip
91767-3802
Phone Number
909-623-6391
Fax Number
909-620-9491
person
Provider Business Mailing Address Details
Address
1050 N Garey Ave
City
Pomona
State
California
Zip
91767-3802
Phone Number
909-623-6391
Fax Number
909-620-9491
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
19-155 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
19-155 (California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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