Provider Demographics
NPI:1497400188
Name:PIMENTEL, JESSICA MAGDALENA (CLC, CBS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MAGDALENA
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:CLC, CBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 TURNPIKE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-6156
Mailing Address - Country:US
Mailing Address - Phone:978-228-1125
Mailing Address - Fax:978-608-8324
Practice Address - Street 1:800 TURNPIKE ST STE 300
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6156
Practice Address - Country:US
Practice Address - Phone:978-228-1125
Practice Address - Fax:978-608-8324
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN