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General NPI Number Information
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NPI Number | 1134637242
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Entity Type | Individual
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Provider Name | JESSICA PORRECA
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Gender | Female
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Dates
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Enumeration Date | 01/11/2018
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 1695 ROBB DR
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City | RENO
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State | NV
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Zip | 89523-3504
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Country | US
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Telephone | 775-746-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3143 ABRUZZI CT
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City | SPARKS
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State | NV
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Zip | 89434-9208
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Country | US
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Telephone | 951-751-8009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 20386
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License Number State | NV
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