Basic Information
| Provider Information | |||||||||
| NPI: | 1992287213 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLIEGO | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | AREAN | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 POPLAR AVE. | ||||||||
| Address2: | BLDG. 2 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012875674 | ||||||||
| FaxNumber: | 9012875674 | ||||||||
| Practice Location | |||||||||
| Address1: | 848 ADAMS AVE. | ||||||||
| Address2: | STE. L400 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 38103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012877337 | ||||||||
| FaxNumber: | 9012874540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2018 | ||||||||
| LastUpdateDate: | 08/19/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | PENDING | TN | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.