Jacob Christian Wickham, CMPSS is a
Peer Specialist based in Campo, California. Jacob Christian Wickham is licensed to practice in California (license number MPSS-ZWRITX) and his current practice location is
1777 Buckman Springs Rd, Campo, California. He can be reached at his office (for appointments etc.) via phone at
(619) 478-5696.
NPI number for Jacob Christian Wickham is 1376306183 and his current mailing address is 1777 Buckman Springs Rd, Campo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376306183.
Healthcare Provider's Profile
Full Name | Jacob Christian Wickham |
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Gender | Male |
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Speciality | Peer Specialist |
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Location | 1777 Buckman Springs Rd, Campo, California |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1376306183
- Provider Enumeration Date: 02/05/2024
- Last Update Date: 09/22/2025
Medical Identifiers
Medical identifiers for Jacob Christian Wickham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1376306183 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | R1536221123 (California) | Secondary |
175T00000X | Peer Specialist | MPSS-ZWRITX (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. Jacob Christian Wickham 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 |
Jacob Christian Wickham, CMPSS 1777 Buckman Springs Rd, Campo, CA 91906-2022 Ph: (619) 478-5696 | Jacob Christian Wickham, CMPSS 1777 Buckman Springs Rd, Campo, CA 91906-2022 Ph: (619) 478-5696 |
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