Basic Information
| Provider Information | |||||||||
| NPI: | 1285039891 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VO | ||||||||
| FirstName: | JESSICA | ||||||||
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| Credential: | P.A.-C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1331 N 7TH ST | ||||||||
| Address2: | SUITE 275 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022543151 | ||||||||
| FaxNumber: | 6022569581 | ||||||||
| Practice Location | |||||||||
| Address1: | 1331 N 7TH ST | ||||||||
| Address2: | SUITE 275 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022543151 | ||||||||
| FaxNumber: | 6022569581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2014 | ||||||||
| LastUpdateDate: | 10/24/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 5908 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.