Provider Demographics
NPI:1982602397
Name:ARENAS, JESSICA LEE (PAC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:ARENAS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:BEISLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:210 S GRAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4205
Mailing Address - Country:US
Mailing Address - Phone:626-335-3527
Mailing Address - Fax:626-963-6196
Practice Address - Street 1:210 S GRAND AVE STE 200
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4205
Practice Address - Country:US
Practice Address - Phone:626-335-3527
Practice Address - Fax:626-963-6196
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine