Provider Demographics
NPI:1386246247
Name:CARO, JESSICA D
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:CARO
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 1:5672 WINWARD CIR
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-7510
Mailing Address - Country:US
Mailing Address - Phone:775-815-8217
Mailing Address - Fax:
Practice Address - Street 1:90 GAULT WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-2322
Practice Address - Country:US
Practice Address - Phone:775-356-5351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker