Provider Demographics
NPI:1932664893
Name:DILLON, JESSICA MARY (NP, RN, MSN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARY
Last Name:DILLON
Suffix:
Gender:F
Credentials:NP, RN, MSN
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2466 LARKSPUR LN APT 351
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4150
Mailing Address - Country:US
Mailing Address - Phone:614-256-6332
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST STE 1700
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95006553363LA2200X, 363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology