MEDICARE: JAYMEE CLARISSE LICERIO CRUZ NP

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
1	363LF0000X	Family Nurse Practitioner	95038226	CA

General Provider Information

NPI Number	:	1710878277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYMEE CLARISSE LICERIO CRUZ NP

Provider Business Mailing Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-6184
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-6184
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	01/14/2026

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Directions to “ JAYMEE CLARISSE LICERIO CRUZ NP” Practice Location

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