Provider Demographics
NPI:1285294975
Name:PINZON, JESSICA A
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:A
Last Name:PINZON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PARK VIEW AVE APT 2503
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-8311
Mailing Address - Country:US
Mailing Address - Phone:908-616-5790
Mailing Address - Fax:
Practice Address - Street 1:33 PARK VIEW AVE APT 2503
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-8311
Practice Address - Country:US
Practice Address - Phone:908-616-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00949300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty