Provider Demographics
NPI:1548369119
Name:SAINT-PAUL, JESSICA DOMINIQUE (PA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:DOMINIQUE
Last Name:SAINT-PAUL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:400 CORPORATE POINTE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7615
Mailing Address - Country:US
Mailing Address - Phone:310-357-6214
Mailing Address - Fax:323-969-0006
Practice Address - Street 1:8732 S SEPULVEDA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-4031
Practice Address - Country:US
Practice Address - Phone:831-200-3774
Practice Address - Fax:323-968-0006
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2020-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant