Provider Demographics
NPI:1851167712
Name:SALAZAR AGUIRRECHEA, JESSIANE
Entity Type:Individual
Prefix:
First Name:JESSIANE
Middle Name:
Last Name:SALAZAR AGUIRRECHEA
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 1:102 CALLE TENERIFE
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-9230
Mailing Address - Country:US
Mailing Address - Phone:787-298-2889
Mailing Address - Fax:
Practice Address - Street 1:102 CALLE TENERIFE
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-9230
Practice Address - Country:US
Practice Address - Phone:787-298-2889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program