Provider Demographics
NPI:1104798016
Name:MCCUMBER, JARRED ROCKY
Entity type:Individual
Prefix:MR
First Name:JARRED
Middle Name:ROCKY
Last Name:MCCUMBER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:WHEATLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95692-9798
Mailing Address - Country:US
Mailing Address - Phone:530-633-3100
Mailing Address - Fax:530-633-3109
Practice Address - Street 1:1010 WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:WHEATLAND
Practice Address - State:CA
Practice Address - Zip Code:95692-9798
Practice Address - Country:US
Practice Address - Phone:530-633-3100
Practice Address - Fax:530-633-3109
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach