Healthcare Provider Details

I. General information

NPI: 1245114701
Provider Name (Legal Business Name): JESSICA ELAINE NASEMENTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ELAINE MUNOZ

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 PATTERSON AVE
CORCORAN CA
93212-1722
US

IV. Provider business mailing address

848 N ARBOR DR
TULARE CA
93274-2307
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-8888
  • Fax:
Mailing address:
  • Phone: 559-759-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95345091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: