Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Jessika Denise Park, AMFT, LPCC

Individual provider Mental Health Counselor · NPI 1477159531

MS. Jessika Denise Park, AMFT, LPCC is a Mental Health Counselor in Stockton, California. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020
Specialties on file
2
What do these letters mean?
LPCC — Licensed Professional Clinical Counselor
The title some states use for a licensed clinical counsellor.

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Practice location Address checks out

1305 Tommydon St
Stockton, CA 95210-3364
Phone: (209) 476-5960
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 19194 (CA)
Marriage & Family Therapist Taxonomy 106H00000X · Licence 131422 (CA)

Record details

NPI number1477159531
Entity typeIndividual (Type 1)
GenderFemale
Credentials AMFT , LPCC
Sole proprietorYes
NPI enumeratedDecember 4, 2020
Last updated in NPPESFebruary 6, 2026
Certification dateFebruary 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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