1093822785 NPI number — JESSICA YORK-FRANCO MA., L.P.C.

Table of content: JESSICA YORK-FRANCO MA., L.P.C. (NPI 1093822785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093822785 NPI number — JESSICA YORK-FRANCO MA., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YORK-FRANCO
Provider First Name:
JESSICA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093822785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6053 LOURDES RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA TERESA
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88008-9138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-227-1255
Provider Business Mailing Address Fax Number:
877-587-9452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 EXECUTIVE CENTER BLVD
Provider Second Line Business Practice Location Address:
STE. 210
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79902-1058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-227-1255
Provider Business Practice Location Address Fax Number:
877-587-9452
Provider Enumeration Date:
08/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  19725 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 19725 . This is a "L.P.C." identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 179266501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 20-4030941 . This is a "TAX IDENTIFICATION NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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