Provider Demographics
NPI:1134697931
Name:AYOTTE, JESSICA RENAYE (LVN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENAYE
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 REDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9728
Mailing Address - Country:US
Mailing Address - Phone:530-616-1682
Mailing Address - Fax:
Practice Address - Street 1:270 COUNTY HOSPITAL RD STE 109
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9173
Practice Address - Country:US
Practice Address - Phone:530-283-6307
Practice Address - Fax:530-283-6045
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN687945164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse