Provider Demographics
NPI:1063134864
Name:YEN, JESSICA RENEE (MSN, RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENEE
Last Name:YEN
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:RENEE
Other - Last Name:ARRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2279 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1514
Mailing Address - Country:US
Mailing Address - Phone:916-734-2716
Mailing Address - Fax:
Practice Address - Street 1:2279 45TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1514
Practice Address - Country:US
Practice Address - Phone:916-734-2716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA656437163WP0218X
CA5006364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
No163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology