JESSICA HETHCOAT
NPI 1558854018
Student in an Organized Health Care Education/Training Program in San Diego, CA

Q: What is Jessica Hethcoat's NPI number?

The NPI number for Jessica Hethcoat is 1558854018. It was assigned to this individual provider in the NPPES registry on June 10, 2018.

Q: What is Jessica Hethcoat's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jessica Hethcoat was last updated on October 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 10, 2018PECOS Enrolled

4077 FIFTH AVE # MER35, SAN DIEGO, CA 92103(619) 260-7220(619) 260-7305 Get Directions Write a Review

NPPES record last updated: October 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Jessica Hethcoat NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA HETHCOAT (NPI 1558854018) is an individual student in an organized health care education/training program in San Diego, California and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558854018

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameJESSICA HETHCOAT

Location Address4077 FIFTH AVE # MER35San Diego, CA 92103-2105

Mailing Address4077 Fifth Ave # Mer35San Diego, CA 92103-2105 · (619) 260-7220 · Fax (619) 260-7305

Phone(619) 260-7220

Fax(619) 260-7305

Sole ProprietorNo

Enumeration DateJune 10, 2018

Last NPPES UpdateOctober 25, 2024

✔ NPI 1558854018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4077 FIFTH AVE # MER35, San Diego, CA 92103

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Hethcoat is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PRANAY RAG BONAGIRI DO

Internal Medicine