Jessica Dian Bryant

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Venice, CA

NPI 1194332189 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1194332189
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
204 Hampton Dr
Venice, CA 90291-2623
Phone
(310) 733-7654
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

204 Hampton Dr
Venice, CA 90291-2623

Mailing address

14220 Burbank Blvd Apt 123
Sherman Oaks, CA 91401-4945
Phone (310) 733-7654

Other providers in Venice, CA

All providers in Venice, CA · Student in an Organized Health Care Education/Training Program in California

Sources for this page

Verify at the official NPI Registry.