Healthcare Provider Details

I. General information

NPI: 1841100161
Provider Name (Legal Business Name): JESSICA NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W 5TH ST
SANTA ANA CA
92701-4599
US

IV. Provider business mailing address

2625 W BAYLOR CIR APT 237
ANAHEIM CA
92801-4914
US

V. Phone/Fax

Practice location:
  • Phone: 714-647-6092
  • Fax:
Mailing address:
  • Phone: 714-986-4472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number698373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: