Healthcare Provider Details

I. General information

NPI: 1205973948
Provider Name (Legal Business Name): JESSICA PICHA C. N. M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA GERTSER C. N. M.

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 5TH AVE STE 300
SAN DIEGO CA
92103-5910
US

IV. Provider business mailing address

10170 SORRENTO VALLEY RD MAIL DROP SV-5
SAN DIEGO CA
92121-1604
US

V. Phone/Fax

Practice location:
  • Phone: 619-688-0770
  • Fax:
Mailing address:
  • Phone: 858-784-5888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number536836
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: