Healthcare Provider Details

I. General information

NPI: 1407433147
Provider Name (Legal Business Name): JENNIFER NICOLE BACHAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD
PALO ALTO CA
94304-1614
US

IV. Provider business mailing address

750 WELCH RD STE 116
PALO ALTO CA
94304-1508
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-8000
  • Fax:
Mailing address:
  • Phone: 650-721-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA202379
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1019624
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: