Provider Demographics
NPI:1376274746
Name:NUNEZ DE YBARRA, JESSICA MARIE (MD, MPH, FACPM)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:NUNEZ DE YBARRA
Suffix:
Gender:F
Credentials:MD, MPH, FACPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95812-0367
Mailing Address - Country:US
Mailing Address - Phone:916-212-6838
Mailing Address - Fax:
Practice Address - Street 1:1615 CAPITOL AVE # MS 0500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-5015
Practice Address - Country:US
Practice Address - Phone:916-889-4351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA699392083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine