Healthcare Provider Details

I. General information

NPI: 1003300518
Provider Name (Legal Business Name): JENNIFER PARDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 BANCROFT AVE STE 133
OAKLAND CA
94605-2480
US

IV. Provider business mailing address

7200 BANCROFT AVE STE 133
OAKLAND CA
94605-2480
US

V. Phone/Fax

Practice location:
  • Phone: 510-553-8500
  • Fax:
Mailing address:
  • Phone: 510-553-8500
  • Fax: 510-553-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: