Provider Demographics
NPI:1316821572
Name:AMAYA, JESSENIA
Entity type:Individual
Prefix:
First Name:JESSENIA
Middle Name:
Last Name:AMAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13073 MILL POND CT
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-8735
Mailing Address - Country:US
Mailing Address - Phone:760-596-5060
Mailing Address - Fax:
Practice Address - Street 1:13073 MILL POND CT
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8735
Practice Address - Country:US
Practice Address - Phone:760-596-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter