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General NPI Number Information
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NPI Number | 1245806850
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Entity Type | Individual
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Provider Name | JESSICA FERNANDEZ NP
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Gender | Female
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 1 SHIELDS AVE
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City | DAVIS
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State | CA
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Zip | 95616-5200
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Country | US
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Telephone | 530-752-1035
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Fax | 707-754-5842
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Provider Business Mailing Address
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Address Line | 949 33RD ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-4410
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Country | US
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Telephone | 818-825-0264
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95014983
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License Number State | CA
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