Healthcare Provider Details

I. General information

NPI: 1932738713
Provider Name (Legal Business Name): JESSICA SHEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31700 TEMECULA PKWY
TEMECULA CA
92592-5896
US

IV. Provider business mailing address

31700 TEMECULA PKWY STE 2
TEMECULA CA
92592-5896
US

V. Phone/Fax

Practice location:
  • Phone: 951-331-2200
  • Fax:
Mailing address:
  • Phone: 951-600-4337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1932738713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: