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General NPI Number Information
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NPI Number | 1982282422
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Entity Type | Individual
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Provider Name | JESSICA MARIE VAN FLEET
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Gender | Female
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 993 AVENIDA PICO STE 120
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-3908
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Country | US
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Telephone | 949-829-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 2995 RED HILL AVE STE 200
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City | COSTA MESA
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State | CA
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Zip | 92626-5984
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Country | US
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Telephone |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A181382
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License Number State | CA
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