Provider Demographics
NPI:1164715470
Name:SIANI, JESSICA ROSE (ND)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ROSE
Last Name:SIANI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 ORANGE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2839
Mailing Address - Country:US
Mailing Address - Phone:949-743-5770
Mailing Address - Fax:949-574-9854
Practice Address - Street 1:1000 N COAST HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-1368
Practice Address - Country:US
Practice Address - Phone:949-715-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-447175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath