Provider Demographics
NPI:1437765393
Name:MORROW, JESSICA JEWEL (RNDT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEWEL
Last Name:MORROW
Suffix:
Gender:F
Credentials:RNDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 CORY CT
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5525
Mailing Address - Country:US
Mailing Address - Phone:805-540-1160
Mailing Address - Fax:
Practice Address - Street 1:466 CORY CT
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5525
Practice Address - Country:US
Practice Address - Phone:805-540-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-16
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69412472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG