Provider Demographics
NPI:1992453989
Name:GALARZA, JESSICA KRISTINA (CPM)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KRISTINA
Last Name:GALARZA
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 41005
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8325
Mailing Address - Country:US
Mailing Address - Phone:787-242-2569
Mailing Address - Fax:
Practice Address - Street 1:CALLE FRANCISCO ROSA, BARRIO CAPAEZ
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-242-2569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRCPM22010008176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty