Provider Demographics
NPI:1033945464
Name:CILIA, JESSICA D
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:CILIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:DEL CARMEN
Other - Last Name:CILIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JESSICA RAMOS
Mailing Address - Street 1:1019 LONGSPUR DR
Mailing Address - Street 2:
Mailing Address - City:SUISUN CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94585-2153
Mailing Address - Country:US
Mailing Address - Phone:415-515-7515
Mailing Address - Fax:
Practice Address - Street 1:1019 LONGSPUR DR
Practice Address - Street 2:
Practice Address - City:SUISUN CITY
Practice Address - State:CA
Practice Address - Zip Code:94585-2153
Practice Address - Country:US
Practice Address - Phone:415-515-7515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA1547464103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst