Provider Demographics
NPI:1083993950
Name:RANGEL, JESSICA CRISTY
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CRISTY
Last Name:RANGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:CRISTY
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 E CINNAMON DR
Mailing Address - Street 2:APT. 349
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2885
Mailing Address - Country:US
Mailing Address - Phone:559-816-9181
Mailing Address - Fax:
Practice Address - Street 1:7170 N FINANCIAL DR
Practice Address - Street 2:SUITE 135
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2939
Practice Address - Country:US
Practice Address - Phone:559-221-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)