Provider Demographics
NPI:1760908677
Name:JINGA, REBECA (PA-C)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:JINGA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25 COMMERCIAL ST APT 301
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4368
Mailing Address - Country:US
Mailing Address - Phone:954-675-4295
Mailing Address - Fax:
Practice Address - Street 1:500 CONGRESS ST STE B1
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0917
Practice Address - Country:US
Practice Address - Phone:617-472-6764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant