Healthcare Provider Details

I. General information

NPI: 1891607487
Provider Name (Legal Business Name): JESSICA DAVIDOFF MCFADDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 S ELISEO DR
GREENBRAE CA
94904-2006
US

IV. Provider business mailing address

150 COVEY RD # B
AUBURN CA
95603-3200
US

V. Phone/Fax

Practice location:
  • Phone: 415-448-1500
  • Fax:
Mailing address:
  • Phone: 206-660-4449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95040641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: