Provider Demographics
NPI:1780390229
Name:GARCIA, JESSICA GONZALEZ (DO)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:GONZALEZ
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95024-0878
Mailing Address - Country:US
Mailing Address - Phone:831-265-7277
Mailing Address - Fax:831-265-7277
Practice Address - Street 1:890 SUNSET DR STE D1B
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5663
Practice Address - Country:US
Practice Address - Phone:831-265-7277
Practice Address - Fax:831-265-7277
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDO71238156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician