Jessica Iudiciani
Individual provider Active NPI School Psychologist · Bloomfield, NM
NPI 1376940775 · NPPES record last updated Dec 1, 2014
Key facts
- NPI
- 1376940775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 325 N Bergin LN
Bloomfield, NM 87413-6729 - Phone
- (505) 632-4389
- NPI assigned
- Dec 1, 2014
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
325 N Bergin LN
Bloomfield, NM 87413-6729
Mailing address
325 N Bergin LN
Bloomfield, NM 87413-6729
Phone (505) 632-4389
Other providers in Bloomfield, NM
- Connie Hernandez
- Roy Hernandez
- Ariel Rose Howard
- Colleen Hudson
- Thomas William Hurst
- Paula Renee Jackson
- Julie Rose Jaramillo
- Cierra Johnson
- Tonya Kaye Jordan
- Kare Inc
All providers in Bloomfield, NM · School Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.