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NPI Code Detail

MEDICARE: JESSICA N OLIVER

MEDICARE: JESSICA N OLIVER
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
1124Q00000XDental Hygienist26050CA

General Provider Information

NPI Number : 1548117500
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA N OLIVER
Provider Business Mailing Address
First Line : 10039 VINE ST
Second Line :
City : LAKESIDE
State : CA
Zip : 92040-3120
Country : US
Telephone Number : 833-867-4642
Fax Number :
Provider Business Practice Location Address
First Line : 10039 VINE ST
Second Line :
City : LAKESIDE
State : CA
Zip : 92040-3120
Country : US
Telephone Number : 833-867-4642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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Directions to “ JESSICA N OLIVER ” Practice Location

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