Provider Demographics
NPI:1306672720
Name:VANSCOY, JESSALYN TEJADA
Entity type:Individual
Prefix:
First Name:JESSALYN
Middle Name:TEJADA
Last Name:VANSCOY
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 1:5000 W SUNSET BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5863
Mailing Address - Country:US
Mailing Address - Phone:323-525-6400
Mailing Address - Fax:
Practice Address - Street 1:5000 W SUNSET BLVD STE 600
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5863
Practice Address - Country:US
Practice Address - Phone:323-525-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program