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JESSICA ACOCK CARLISLE
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1073099479
Individual Registrant: JESSICA ACOCK CARLISLE
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2222 BANCROFT WAY SPC 4300 BERKELEY, CA 94720-4300 US
Tel: 510-642-2367 Fax: --
Tel: 510-642-2367 Fax: --
Contact information for business:
1219B KIRKHAM ST SAN FRANCISCO, CA 94122-3420 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1073099479
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 390200000X | Student Organized Health Care Education/Training Program |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
