Provider Demographics
NPI:1235709007
Name:LAMPKIN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LAMPKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 S MILLIKEN AVE STE F
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-8102
Mailing Address - Country:US
Mailing Address - Phone:909-390-2466
Mailing Address - Fax:
Practice Address - Street 1:603 S MILLIKEN AVE STE F
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-8102
Practice Address - Country:US
Practice Address - Phone:909-390-2466
Practice Address - Fax:909-912-8152
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA331950222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist