Provider Demographics
NPI:1063572485
Name:NEGRON, JESSICA S (PSY D)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:S
Last Name:NEGRON
Suffix:
Gender:
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3877 N 7TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5061
Mailing Address - Country:US
Mailing Address - Phone:602-258-6797
Mailing Address - Fax:
Practice Address - Street 1:8410 W THOMAS RD STE 116
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3356
Practice Address - Country:US
Practice Address - Phone:602-258-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1786103TC0700X
AZ005960103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical