Provider Demographics
NPI:1801135827
Name:COX, JESSICA L (LVN)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:COX
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LVN
Mailing Address - Street 1:18980 DECKER RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-7161
Mailing Address - Country:US
Mailing Address - Phone:310-208-9346
Mailing Address - Fax:
Practice Address - Street 1:18980 DECKER RD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-7161
Practice Address - Country:US
Practice Address - Phone:310-208-9346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 220874164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse