MEDICARE: JESSICA BROOKS DO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1790629632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA BROOKS DO

Provider Business Mailing Address
First Line	:	1770 N ORANGE GROVE AVE STE 201
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-3027
Country	:	US
Telephone Number	:	909-469-9490
Fax Number	:	909-865-9601

Provider Business Practice Location Address
First Line	:	1770 N ORANGE GROVE AVE STE 101
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91767-3027
Country	:	US
Telephone Number	:	909-469-9494
Fax Number	:	909-469-2120

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	06/29/2026

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