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General NPI Number Information
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NPI Number | 1861063539
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Entity Type | Individual
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Provider Name | JESSICA JOLEENE JAMES LMT
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Gender | Female
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Dates
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Enumeration Date | 07/05/2021
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 4209 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1103
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Country | US
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Telephone | 505-225-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 MONTGOMERY BLVD NE APT 313
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1086
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Country | US
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Telephone | 505-225-2555
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 8991
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 8991
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License Number State | NM
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