Individual
JESSICA MICCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 696-4300
Mailing address
6225 COUNTY ROAD 23, ORLAND, CA 95963-9491
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2022
Last updated
06/16/2025
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