Provider Demographics
NPI:1376437392
Name:LORGERODRIGUEZ, JESSICA LYNN (RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:LORGERODRIGUEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-3218
Mailing Address - Country:US
Mailing Address - Phone:350-503-9068
Mailing Address - Fax:
Practice Address - Street 1:2401 E ORANGEBURG AVE STE 3302401E
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-3351
Practice Address - Country:US
Practice Address - Phone:350-503-9068
Practice Address - Fax:209-724-6034
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95336039163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care