Healthcare Provider Details

I. General information

NPI: 1225978265
Provider Name (Legal Business Name): JESSICA NADEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA BRAICA RDH-DENTAL HYGIENIST

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57227 ARANZA CT
YUCCA VALLEY CA
92284-9514
US

IV. Provider business mailing address

57227 ARANZA CT
YUCCA VALLEY CA
92284-9514
US

V. Phone/Fax

Practice location:
  • Phone: 413-218-1297
  • Fax:
Mailing address:
  • Phone: 413-218-1297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH88518
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: