Individual provider · Type 1 NPI
Jessica Bullock, PMHNP, RN
Psychiatric/Mental Health Nurse Practitioner · San Jose, CA
NPI number
1750823530
Active
Practice location
4850 Union Ave
San Jose, CA 95124-5156
Mailing address
4831 Rivervale Dr
Soquel, CA 95073-9727
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 95146518 (CA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95019999 (CA) |
| Registered Nurse | 163W00000X | 201242077RN (OR) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1750823530
Jessica Bullock, PMHNP, RN's National Provider Identifier is 1750823530, issued on Nov 10, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Jose, CA. The record was last updated on Oct 16, 2025.