Provider Demographics
NPI:1659916765
Name:DIGGS, JESSICA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DIGGS
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 S BROADWAY OFC 404
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-1807
Mailing Address - Country:US
Mailing Address - Phone:323-844-2012
Mailing Address - Fax:213-516-8563
Practice Address - Street 1:612 S BROADWAY OFC 404
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90014-1807
Practice Address - Country:US
Practice Address - Phone:323-844-2012
Practice Address - Fax:213-516-8563
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM595176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife