Individual provider · Type 1 NPI

Jessica Wall Divine, MD

Family Medicine Physician · Santa Cruz, CA

NPI number 1184065930 Active

Practice location

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Call (831) 454-4100 Map

Fax (831) 454-4488

Other practice locations

  • 2575 E Bidwell St Ste 250, Folsom, CA 95630-6447 · (916) 817-3700

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X0116026459 (VA)
Family Medicine Physician Primary 207Q00000X145258 (CA)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

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About NPI 1184065930

Jessica Wall Divine, MD's National Provider Identifier is 1184065930, issued on Jul 9, 2013. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Santa Cruz, CA. The record was last updated on Feb 19, 2025.