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Individual
JESSICA MARTIN
Active
Individual
JESSICA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
PA55234
CA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/05/2018
Last updated
06/18/2018
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