Provider Demographics
NPI:1699963934
Name:SINACORI, JESSICA (MED)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SINACORI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 SW CYBER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1045
Mailing Address - Country:US
Mailing Address - Phone:541-203-0395
Mailing Address - Fax:
Practice Address - Street 1:345 SW CYBER DR STE 104
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1045
Practice Address - Country:US
Practice Address - Phone:541-203-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist