Jefferson, Carl Frederick
Jefferson, Carl Frederick is an individual health care provider with primary practice located at 500 Crown Point Cir , Grass Valley CA 95945-9561. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is his primary health care specialty. Jefferson, Carl Frederick can be contacted via phone (530) 470-2759.Contact Information
Primary practice address
500 Crown Point Cir
Grass Valley CA 95945-9561
Phone: (530) 470-2759
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1063546083 |
|---|---|
| LBN Legal business name | Jefferson, Carl Frederick |
| Credentials | C.A.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2007 |
| Last updated | Dec 28th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063546083 | NPPES |
| California | Other | 1824 | C.A.S. |
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