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General NPI Number Information
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NPI Number | 1659195519
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Entity Type | Individual
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Provider Name | JESSICA JASMIN GARCIA MEDRANO
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 104 WALNUT AVE STE 208
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3929
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Country | US
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Telephone | 831-423-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 PORTOLA DR SPC 10
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City | SANTA CRUZ
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State | CA
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Zip | 95062-5153
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Country | US
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Telephone | 831-291-7755
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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