DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACOB BURTON WICKENHEISER, L.C.S.W.

Deactivated Sole Proprietor

JACOB BURTON WICKENHEISER, L.C.S.W. is a Clinical Social Worker healthcare provider located in SACRAMENTO, California. NPI 1205958980 is deactivated in the NPPES registry. Verify at CMS.

Clinical Social Worker · SACRAMENTO, CA

This NPI has been deactivated. The record was deactivated on October 24, 2013. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1205958980
Provider Type
Individual
Gender
Male
NPI Issued
Apr 4, 2007 (6.5561643835616 yrs)
Last Updated
Sep 22, 2022
Deactivated
Oct 24, 2013
License
26297 (CA)
Sole Proprietor
Yes

Practice Information

Address
1526 WATERWHEEL DR
SACRAMENTO, CA, 958332390
Browse CA providers · Browse ZIP 95833
Phone
5107032113
Primary Specialty
Clinical Social Worker
1041C0700X

Other Clinical Social Worker Providers in SACRAMENTO, CA

Name Credential NPI
MRS. NATALIE ROSE DAYLAMI LCSW 1699774737
JODIE LYNN SAKARIS LCSW 1447233630
MRS. HOLLY D BLEASDALE LCSW 1568445690
LINDA G BOYERS MSW 1306820055
MS. MARLENE RICE MSW 1235114885
SHARON REA ZONE LCSW 1831174218
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.