Provider Demographics
NPI:1316522428
Name:SIMPSON, JESSICA ESPINOZA (IBCLC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ESPINOZA
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 HEATHERFORD CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7273
Mailing Address - Country:US
Mailing Address - Phone:571-259-3006
Mailing Address - Fax:
Practice Address - Street 1:5401 HEATHERFORD CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7273
Practice Address - Country:US
Practice Address - Phone:571-259-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty