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NPI Code Detail

MEDICARE: MS. JESSICA FUMANTI BHSII

MEDICARE: MS. JESSICA FUMANTI BHSII
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1063638955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA FUMANTI BHSII
Provider Business Mailing Address
First Line : 1370 SOUTH STATE STREET
Second Line : SUITE B
City : SAN JACINTO
State : CA
Zip : 92583
Country : US
Telephone Number : 951-791-3122
Fax Number : 951-791-3397
Provider Business Practice Location Address
First Line : 1370 S STATE ST # B
Second Line :
City : SAN JACINTO
State : CA
Zip : 92583-4933
Country : US
Telephone Number : 951-791-3122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2007
Last Update Date : 01/28/2011

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