Provider Demographics
NPI:1255204038
Name:MAIMBA, JESCA (RN, BSN, MPH)
Entity type:Individual
Prefix:
First Name:JESCA
Middle Name:
Last Name:MAIMBA
Suffix:
Gender:F
Credentials:RN, BSN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3375 JUBILEE DR
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-9137
Mailing Address - Country:US
Mailing Address - Phone:209-835-1500
Mailing Address - Fax:
Practice Address - Street 1:3375 JUBILEE DR
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-9137
Practice Address - Country:US
Practice Address - Phone:209-835-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA758455163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse