Healthcare Provider Details

I. General information

NPI: 1295362374
Provider Name (Legal Business Name): JESSICA GABRIELIAN WOOSTER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ISABELLE GABRIELIAN DO

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 N MINNESOTA ST
CARSON CITY NV
89703-3850
US

IV. Provider business mailing address

1080 N MINNESOTA ST
CARSON CITY NV
89703-3850
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7350
  • Fax:
Mailing address:
  • Phone: 775-445-7350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDO3754
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: