Healthcare Provider Details

I. General information

NPI: 1548444276
Provider Name (Legal Business Name): JAYNE SHER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAYNE REISNER RN

II. Dates (important events)

Enumeration Date: 12/17/2007
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BANCROFT AVE SUITE 202
OAKLAND CA
94605-2403
US

IV. Provider business mailing address

3151 MIDDLEFIELD AVE
FREMONT CA
94539-5069
US

V. Phone/Fax

Practice location:
  • Phone: 510-383-5213
  • Fax: 510-383-5183
Mailing address:
  • Phone: 510-383-5213
  • Fax: 510-383-5183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number304838
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: