Healthcare Provider Details

I. General information

NPI: 1962343772
Provider Name (Legal Business Name): JESSICA ROSS MSN, RNC-OB, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CAPITOL AVE
FREMONT CA
94538-1483
US

IV. Provider business mailing address

440 N BARRANCA AVE # 4117
COVINA CA
91723-1722
US

V. Phone/Fax

Practice location:
  • Phone: 925-502-1447
  • Fax:
Mailing address:
  • Phone: 925-502-1447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SN0000X
TaxonomyNeonatal Clinical Nurse Specialist
License Number3998
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number3998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: