Individual
JESSICA ELIZABETH PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
21634 RETREAT PKWY, CORONA, CA 92883-6100
(951) 493-6916
(951) 826-8120
Mailing address
21634 RETREAT PKWY, CORONA, CA 92883-6100
(951) 493-6916
(951) 826-8120
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TL.0005639
CO
207RP1001X
Pulmonary Disease Physician
Primary
20A18831
CA
Other
Enumeration date
06/14/2015
Last updated
04/14/2025
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