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NPI Code Detail

MEDICARE: JESSICA TODD RN

MEDICARE: JESSICA TODD RN
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
1163WE0003XEmergency Registered Nurse836537CA
2163W00000XRegistered Nurse836537CA

General Provider Information

NPI Number : 1568206977
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA TODD RN
Provider Business Mailing Address
First Line : 7604 KENSINGTON DR
Second Line :
City : CITRUS HEIGHTS
State : CA
Zip : 95610-6724
Country : US
Telephone Number : 916-666-9195
Fax Number :
Provider Business Practice Location Address
First Line : 3037 BRYANT PL
Second Line :
City : DAVIS
State : CA
Zip : 95618-1613
Country : US
Telephone Number : 916-666-9195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2024
Last Update Date : 06/20/2024

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