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General NPI Number Information
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NPI Number | 1376437392
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Entity Type | Individual
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Provider Name | JESSICA LYNN LORGERODRIGUEZ RN
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Gender | Female
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2401 E ORANGEBURG AVE STE 3302401E
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City | MODESTO
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State | CA
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Zip | 95355-3351
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Country | US
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Telephone | 350-503-9068
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Fax | 209-724-6034
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Provider Business Mailing Address
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Address Line | 434 COLORADO AVE
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City | MODESTO
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State | CA
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Zip | 95351-3218
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Country | US
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Telephone | 350-503-9068
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 95336039
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License Number State | CA
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