Provider Demographics
NPI:1851197354
Name:ROSS, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:ROSS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CROWN POINT CIR STE 125
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-9538
Mailing Address - Country:US
Mailing Address - Phone:530-273-5440
Mailing Address - Fax:530-273-5479
Practice Address - Street 1:333 CROWN POINT CIR STE 125
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-9538
Practice Address - Country:US
Practice Address - Phone:530-273-5440
Practice Address - Fax:530-273-5479
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker