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General NPI Number Information
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NPI Number | 1972428530
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Entity Type | Individual
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Provider Name | JESSICA MICHELLE BISSONTZ CPO
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Gender | Female
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Dates
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Enumeration Date | 08/12/2026
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Last Update Date | 08/12/2026
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Provider Practice Location Address
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Address Line | 1401 N TUSTIN AVE STE 310
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City | SANTA ANA
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State | CA
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Zip | 92705-8699
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Country | US
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Telephone | 949-988-7928
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Fax | 949-861-9539
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Provider Business Mailing Address
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Address Line | 1401 N TUSTIN AVE STE 310
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City | SANTA ANA
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State | CA
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Zip | 92705-8699
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Country | US
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Telephone | 949-988-7928
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Fax | 949-861-9539
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | CPO04787
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | CPO04787
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License Number State | CA
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