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General NPI Number Information
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NPI Number | 1417749961
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Entity Type | Individual
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Provider Name | JESSICA ABIGAIL BAUTISTA ALEJANDRO
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 11848 BERNARDO PLAZA CT STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92128-2417
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Country | US
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Telephone | 858-217-2496
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Fax |
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Provider Business Mailing Address
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Address Line | 259 S MOLLISON AVE APT 16
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City | EL CAJON
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State | CA
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Zip | 92020-4878
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Country | US
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Telephone | 805-363-4885
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 96518
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License Number State | CA
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