Provider Demographics
NPI:1043923295
Name:GARCIA, JESSICA (NP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21321 E OCOTILLO RD STE 133
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5995
Mailing Address - Country:US
Mailing Address - Phone:480-987-5525
Mailing Address - Fax:480-987-5115
Practice Address - Street 1:21321 E OCOTILLO RD STE 133
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-5995
Practice Address - Country:US
Practice Address - Phone:480-987-5525
Practice Address - Fax:480-987-5115
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRNP285425363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health