Provider Demographics
NPI:1326750654
Name:DIOKNO, JESSICA RIO
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RIO
Last Name:DIOKNO
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 1:2240 TWELVE OAKS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6970
Mailing Address - Country:US
Mailing Address - Phone:813-838-4807
Mailing Address - Fax:
Practice Address - Street 1:4426 CROSSWHITE CT
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0591
Practice Address - Country:US
Practice Address - Phone:352-346-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH23164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health