Jessica Adesuwa Agbonkpolo, MS, LCSW is a
Counselor - Mental Health based in San Bernardino, California. Jessica Adesuwa Agbonkpolo is licensed to practice in California (license number 111363) and her current practice location is
255 N D St Ste 400, San Bernardino, California. She can be reached at her office (for appointments etc.) via phone at
(909) 567-2808.
NPI number for Jessica Adesuwa Agbonkpolo is 1508609850 and her current mailing address is 255 N D St Ste 400, San Bernardino, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1508609850.
Healthcare Provider's Profile
Full Name | Jessica Adesuwa Agbonkpolo |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 255 N D St Ste 400, San Bernardino, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1508609850
- Provider Enumeration Date: 06/14/2024
- Last Update Date: 06/14/2024
Medical Identifiers
Medical identifiers for Jessica Adesuwa Agbonkpolo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508609850 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 111363 (California) | Secondary |
101YM0800X | Counselor - Mental Health | 111363 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Adesuwa Agbonkpolo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jessica Adesuwa Agbonkpolo, MS, LCSW 255 N D St Ste 400, San Bernardino, CA 92401-1715 Ph: (909) 567-2808 | Jessica Adesuwa Agbonkpolo, MS, LCSW 255 N D St Ste 400, San Bernardino, CA 92401-1715 Ph: (909) 567-2808 |
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