MEDICARE: JESSICA NICOLE FLORES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	95070504	CA

General Provider Information

NPI Number	:	1184595936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA NICOLE FLORES

Provider Business Mailing Address
First Line	:	1331 E AVENUE J8
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-5056
Country	:	US
Telephone Number	:	661-488-8685
Fax Number	:

Provider Business Practice Location Address
First Line	:	44711 CEDAR AVE
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-3216
Country	:	US
Telephone Number	:	661-488-8685
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	09/15/2025

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