Provider Demographics
NPI:1538715834
Name:DZIESZKO, JESSICA CHRISTINA (DC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:CHRISTINA
Last Name:DZIESZKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 WASHINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-2345
Mailing Address - Country:US
Mailing Address - Phone:415-788-8700
Mailing Address - Fax:415-788-8702
Practice Address - Street 1:425 WASHINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-2345
Practice Address - Country:US
Practice Address - Phone:415-788-8700
Practice Address - Fax:415-788-8702
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor