Provider Demographics
NPI:1891559381
Name:SANTANA, JESSICA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SANTANA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 OAK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2150
Mailing Address - Country:US
Mailing Address - Phone:915-315-9494
Mailing Address - Fax:
Practice Address - Street 1:305 S JUPITER RD STE 200
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3050
Practice Address - Country:US
Practice Address - Phone:214-785-7426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional