Provider Demographics
NPI:1780918409
Name:VOLLEBREGT, JESSICA ASHLEY CONE (PA-C)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ASHLEY CONE
Last Name:VOLLEBREGT
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:5 JOURNEY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5336
Mailing Address - Country:US
Mailing Address - Phone:949-305-7122
Mailing Address - Fax:949-305-7160
Practice Address - Street 1:26991 CROWN VALLEY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6528
Practice Address - Country:US
Practice Address - Phone:949-582-5430
Practice Address - Fax:949-348-9513
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2019-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20549363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant