Healthcare Provider Details

I. General information

NPI: 1184597510
Provider Name (Legal Business Name): JESSICA PEDROZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 E YOSEMITE AVE STE E
MERCED CA
95340-8055
US

IV. Provider business mailing address

767 E YOSEMITE AVE STE E
MERCED CA
95340-8055
US

V. Phone/Fax

Practice location:
  • Phone: 213-259-0245
  • Fax:
Mailing address:
  • Phone: 213-259-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: