Provider Demographics
NPI:1538885587
Name:LAMANUZZI, JESSI (NP)
Entity type:Individual
Prefix:
First Name:JESSI
Middle Name:
Last Name:LAMANUZZI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10650 GOLF LINKS RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:CA
Mailing Address - Zip Code:95327-9672
Mailing Address - Country:US
Mailing Address - Phone:209-770-2127
Mailing Address - Fax:
Practice Address - Street 1:19526 HILLSDALE DR STE C
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-9234
Practice Address - Country:US
Practice Address - Phone:209-214-9430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022970363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner