Individual ProviderJessica WangPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address2010 Zonal Ave # 1p10, Los Angeles, CA 90033-1026(323) 409-5555PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Wang is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1467156547Provider TypeIndividualFull NameWang, JessicaCredentialMDGenderFemaleSole ProprietorNoEnumeration Date3/30/2023Last Updated5/12/2025Contact InformationPractice LocationPractice Address2010 Zonal Ave # 1p10, Los Angeles, CA 90033-1026Phone(323) 409-5555FaxUnlisted FaxMailing LocationMailing Address2010 Zonal Ave # 1p10, Los Angeles, CA 90033-1026PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseA196560CaliforniaCode174400000XDescriptionSpecialistOther Service ProvidersLicenseA196560CaliforniaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer