Healthcare Provider Details

I. General information

NPI: 1275249427
Provider Name (Legal Business Name): JENNIFER TRAM FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W PARR AVE STE A
LOS GATOS CA
95032-1416
US

IV. Provider business mailing address

700 W PARR AVE STE A
LOS GATOS CA
95032-1416
US

V. Phone/Fax

Practice location:
  • Phone: 408-871-3400
  • Fax: 650-934-2337
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209029420
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95024077
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: