Healthcare Provider Details

I. General information

NPI: 1407057334
Provider Name (Legal Business Name): JENNIFER CHILDREY BOND RN, CNS, CPNP, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD 3 WEST
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

10 CARRIAGE CT
LOS ALTOS CA
94022-1751
US

V. Phone/Fax

Practice location:
  • Phone: 650-949-2856
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN 607808
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberPNP 15067
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberCNS 2088
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: