Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jessica Wall Divine, MD

Individual provider Family Medicine Physician · NPI 1184065930

Dr. Jessica Wall Divine, MD is a Family Practice in Santa Cruz, California. Qualified in 2013, 13 years ago. Practices with County of Santa Cruz, a 66-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Virginia.

Years since qualifying
13
Licensed in
CA, VA
In the registry since
2013
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone: (831) 454-4100
Fax: (831) 454-4488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 145258 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 0116026459 (VA)

Record details

NPI number1184065930
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 9, 2013
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice County Of Santa Cruz — 66 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Santa Cruz