Provider Demographics
NPI:1891391470
Name:ZBERCEA, JESSICA NANCY
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NANCY
Last Name:ZBERCEA
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 1:161 N DOGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4573
Mailing Address - Country:US
Mailing Address - Phone:916-798-3530
Mailing Address - Fax:
Practice Address - Street 1:161 N DOGWOOD ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4573
Practice Address - Country:US
Practice Address - Phone:916-798-3530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95148562163W00000X
CA95017460363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse