Jessica Kirstine Vancil, PA-C
Physician Assistant in Alta Loma, CA. Individual provider (NPI-1).
NPI number1427367259
StatusActive
Last updated in NPPESSep 28, 2010
Details
- NPI
- 1427367259
- Entity type
- Individual (NPI-1)
- Name
- Jessica Kirstine Vancil
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2010
- Last updated
- Sep 28, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA21195 | CA | Yes |
Practice location
6375 Layton StAlta Loma, CA 91701-4165
Phone 909-969-4254
Mailing address
6375 Layton StAlta Loma, CA 91701-4165
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