Provider Demographics
NPI:1427351204
Name:VARGISH, JESSICA ZOE (LICENSED ACUPUNCTURI)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ZOE
Last Name:VARGISH
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 MISSION ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2476
Mailing Address - Country:US
Mailing Address - Phone:415-282-8989
Mailing Address - Fax:415-920-0205
Practice Address - Street 1:2460 MISSION ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2476
Practice Address - Country:US
Practice Address - Phone:415-282-8989
Practice Address - Fax:415-920-0205
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA750171100000X
CAAC10359171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist