Healthcare Provider Details

I. General information

NPI: 1346581535
Provider Name (Legal Business Name): JESSICA CORN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA JANG

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HARRIS CT STE 201
MONTEREY CA
93940-5750
US

IV. Provider business mailing address

1804 EMBARCADERO RD STE 100
PALO ALTO CA
94303-3318
US

V. Phone/Fax

Practice location:
  • Phone: 831-375-4105
  • Fax: 831-372-5722
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22681
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number22681
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN001836
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: