Most Relevant Information
Provider Data
| NPI Number: | 1003500844 |
| Provider Name: | JESSICA GARDNER |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/05/2023 |
| Last Updated: | 06/05/2023 |
Provider Practice Location
3132 JEFFERSON ST
SAN DIEGO
CA
921104421
Practice Location Phone/Fax
| Phone: | 6196833100 |
| Fax: |
Provider Mailing Location
3132 JEFFERSON ST
SAN DIEGO
CA
921104421
Provider Mailing Phone/Fax
| Phone: | 6196833100 |
| Fax: |