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General NPI Number Information
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NPI Number | 1891292512
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Entity Type | Individual
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Provider Name | JESSICA ELISE SCHNEIDER PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 808 OAK AVE
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City | GREENFIELD
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State | CA
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Zip | 93927-5648
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Country | US
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Telephone | 831-674-5334
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 KINGS PARK RD
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City | MEMPHIS
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State | TN
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Zip | 38117-5433
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Country | US
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Telephone | 901-230-1331
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 55361
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License Number State | CA
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