Healthcare Provider Details

I. General information

NPI: 1013804574
Provider Name (Legal Business Name): JESSICA AILENE TOLEDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 8TH ST
EL CENTRO CA
92243-2302
US

IV. Provider business mailing address

1579 W HAMILTON AVE
EL CENTRO CA
92243-3713
US

V. Phone/Fax

Practice location:
  • Phone: 442-265-1525
  • Fax:
Mailing address:
  • Phone: 442-265-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: