Individual
JESSICA BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
333 CORPORATE DR STE 200, LADERA RANCH, CA 92694-2179
(949) 347-7200
Mailing address
21882 JINETES, MISSION VIEJO, CA 92691-1114
(310) 897-1840
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
95007023
CA
Other
Enumeration date
06/19/2015
Last updated
06/04/2025
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