Individual
MRS. JESSICA M MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
77 CASA ST, SUITE 103, SAN LUIS OBISPO, CA 93405-5803
(805) 546-0411
(805) 489-1421
Mailing address
921 OAK PARK BLVD, SUITE 201, PISMO BEACH, CA 93449-3264
(805) 546-0411
(805) 489-1421
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP 16098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP 16098
NURSE PRACTICER
CA
Enumeration date
08/16/2006
Last updated
01/11/2011
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