Provider Demographics
NPI:1811424393
Name:BICKFORD, JESSICA S (MS, RD, CDE)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:BICKFORD
Suffix:
Gender:F
Credentials:MS, RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1548
Mailing Address - Country:US
Mailing Address - Phone:805-826-1381
Mailing Address - Fax:805-648-6706
Practice Address - Street 1:2605 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1548
Practice Address - Country:US
Practice Address - Phone:805-826-1381
Practice Address - Fax:805-648-6706
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered