Provider Demographics
NPI:1518584119
Name:CRESPO SANCHEZ, JESSICA KRISTAL
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KRISTAL
Last Name:CRESPO SANCHEZ
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 1:25 CALLE LOS MILAGROS
Mailing Address - Street 2:
Mailing Address - City:CIALES
Mailing Address - State:PR
Mailing Address - Zip Code:00638-3364
Mailing Address - Country:US
Mailing Address - Phone:787-212-8914
Mailing Address - Fax:
Practice Address - Street 1:25 CALLE LOS MILAGROS
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3364
Practice Address - Country:US
Practice Address - Phone:787-212-8914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program