JESSICA R ELACK (NPI# 1053923193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053923193 |
| Entity Type | Individual |
| Full Name | JESSICA R ELACK |
| Credential | RADT |
| Practice Address |
730 Sunrise Avenue Building 200, Ste-201 Roseville CA 95661 |
| Practice Telephone | 9167823737 |
| Mailing Telephone | 9167823737 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
R1402020820 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1530 3rd St Ste 111, Lincoln, CA 956482501 | 9168840015 |
| Street Address |
730 SUNRISE AVENUE BUILDING 200, STE-201 |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275617367 | Thomas George Dwyer | Dentist | 730 Sunrise Avenue, #110, Roseville, CA 95661-4549 | 2006-10-25 |
| 1083222764 | Lori A Woods | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2020-07-17 |
| 1265069397 | Cassandra Harrison | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2020-03-26 |
| 1699314088 | Shamari Roy | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2020-01-02 |
| 1407495880 | Chanel C Segovia | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2020-01-02 |
| 1265076616 | Miranda L Mcqueen | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2019-10-29 |
| 1457819492 | Latoya Williams | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661-4553 | 2019-03-08 |
| 1407325806 | Michelle Rosetta Wright | Marriage & Family Therapist | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2018-11-15 |
| 1427309525 | Hilario Fortuna | Counselor | 730 Sunrise Avenue, Building 200, Ste-210-250, Roseville, CA 95661-9566 | 2012-09-28 |
| 1649463191 | David S Ellingson | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2007-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013575364 | William Henry Hoffman IIi | Counselor | 2467 Sheldon St, Roseville, MN 55113-3138 | 2019-06-02 |
| 1962987560 | Bradley Thomas Conley | Counselor | 2233 Hamline Ave N Ste 110, Roseville, MN 55113-5002 | 2018-09-28 |
| 1386156065 | Gina M Nunez | Counselor | 730 Sunrise Ave Ste 200-201, Roseville, CA 95661-4567 | 2017-11-02 |
| 1023540515 | Dawn New Awakening LLC | Counselor | 26316 Ronald St, Roseville, MI 48066-4458 | 2017-04-03 |
| 1962809699 | Michael Walsh Gannon | Counselor | 109 Cloud Touch Ct, Roseville, CA 95747-7116 | 2014-11-24 |
| 1700210218 | Ozlem Tekelioglu | Counselor | 1133 Coloma Way Suite C, Roseville, CA 95661 | 2013-09-03 |
| 1114369816 | Amanda Macmillan | Counselor | 101 Cirby Hills Drive, Roseville, CA 95678 | 2013-07-23 |
| 1316295082 | Pes-ebs.inc. | Counselor | 340 Lincoln St, Roseville, CA 95678-2230 | 2012-08-28 |
| 1871860890 | Raymond Richard Evans | Counselor | 2499 Rice Street, Roseville, MN 55113 | 2011-11-18 |
| 1023308079 | Jennica Rachel Jenkins | Counselor | 1899 E Roseville Pkwy Ste 140, Roseville, CA 95661-7980 | 2011-04-12 |
| Find all providers in ROSEVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.