Gustafson, Jill
Gustafson, Jill is an sole proprietor health care provider with primary practice located at 493 Main St , Diamond Springs CA 95619-9173. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gustafson, Jill can be contacted via phone (530) 644-8013.Contact Information
Primary practice address
493 Main St
Diamond Springs CA 95619-9173
Phone: (530) 644-8013
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCS15684 | California |
Profile Details
| NPI number | 1427171099 |
|---|---|
| LBN Legal business name | Gustafson, Jill |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 9th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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