Healthcare Provider Details

I. General information

NPI: 1104257583
Provider Name (Legal Business Name): JENNIFER ANN SCHULMEISTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 12/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 BANCROFT WAY
BERKELEY CA
94720-4301
US

IV. Provider business mailing address

833 MARIN RD
EL SOBRANTE CA
94803-1321
US

V. Phone/Fax

Practice location:
  • Phone: 510-643-7110
  • Fax:
Mailing address:
  • Phone: 510-275-3228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: