Healthcare Provider Details

I. General information

NPI: 1225239684
Provider Name (Legal Business Name): JESSICA LOWE BRENNAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA JERMANE LOWE NP

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 PARKER AVE
SAN FRANCISCO CA
94118-2607
US

IV. Provider business mailing address

119 PARKER AVE
SAN FRANCISCO CA
94118-2607
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-2423
  • Fax: 415-476-9976
Mailing address:
  • Phone: 415-473-2423
  • Fax: 415-476-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number15126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: