Karen Ann Jacka is a Clinical in Lodi, California. Karen Ann Jacka practices all healthcare services and medical treatments related to Clinical. The NPI Number for Karen Ann Jacka is 1790908788. The last update date is 2018-08-27.
Karen Ann Jacka's current location address is 21 S California St, Lodi, California. You can contact this provider via phone number 2094836474 and fax number 2093674696. The mailing address for Karen Ann Jacka is 21 S California St, Lodi, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Karen Ann Jacka |
|---|---|
| Address | 21 S California St, Lodi, California |
| Phone Number | 2094836474 |
| Fax Number | 2093674696 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1790908788 |
|---|---|
| Provider Enumeration Date | 2007-04-10 |
| Last Updated Date | 2018-08-27 |
Provider Mailing Address Detail
| Address | 21 S California St |
|---|---|
| City | Lodi |
| State | California (CA) |
| Post Code | 952401907 |
| Phone Number | 2094836474 |
| Fax Number | 2093674696 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS16470 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3810106 | CA | PROVIDER # AETNA | |
| 48809 | CA | PRIVIDER NUMBER MHN | |
| A881670 | CA | VALUE OPITIONS VENDOR NUM | |
| 62-79934 | CA | PROV. NO.UNITED HEALTH CA |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Karen Ann Jacka by the Centers for Medicare & Medicaid Services?
The Karen Ann Jacka has been issued the NPI (National Provider Identifier) 1790908788 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Karen Ann Jacka is located?
The Karen Ann Jacka is situated at the following address: 21 S California St, Lodi, CA, 952401907.
What is Karen Ann Jacka's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Karen Ann Jacka is Clinical, and the taxonomy classification code that categorizes this area of expertise is 1041C0700X.
On what date did Karen Ann Jacka receive its 1790908788 assignment from the Centers for Medicare & Medicaid Services?
The Karen Ann Jacka was assigned its 1790908788 on 2007-04-10, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Karen Ann Jacka's information last updated?
The Karen Ann Jacka's information was last updated on 2018-08-27.