Provider Demographics
NPI:1053089300
Name:JESSICA LEVATINO MD INC
Entity Type:Organization
Organization Name:JESSICA LEVATINO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVATINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-688-1770
Mailing Address - Street 1:211 QUARRY RD STE MC5993
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1416
Mailing Address - Country:US
Mailing Address - Phone:858-688-1770
Mailing Address - Fax:650-325-1816
Practice Address - Street 1:211 QUARRY RD STE MC5993
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1416
Practice Address - Country:US
Practice Address - Phone:858-688-1770
Practice Address - Fax:650-325-1816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care