Individual
JESSICA TA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120 S DOBSON RD STE 115, CHANDLER, AZ 85286-6166
(602) 843-2991
Mailing address
601 N 3RD AVE UNIT 1216, PHOENIX, AZ 85003-1784
(954) 940-1285
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
10924
AZ
363A00000X
Physician Assistant
Primary
10924
AZ
Other
Enumeration date
07/12/2022
Last updated
03/03/2025
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