Jessica D Fan, PA-C
Physician Assistant, Medical in Claremont, CA. Individual provider (NPI-1).
NPI number1982153292
StatusActive
Last updated in NPPESOct 11, 2023
Details
- NPI
- 1982153292
- Entity type
- Individual (NPI-1)
- Name
- Jessica D Fan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2016
- Certification date
- Oct 11, 2023
- Last updated
- Oct 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA53780 | CA | Yes |
Practice location
981 W Foothill BlvdClaremont, CA 91711-3304
Phone 909-667-7769
Mailing address
981 W Foothill BlvdClaremont, CA 91711-3304
Phone 909-667-7769
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