Healthcare Provider Details

I. General information

NPI: 1275997462
Provider Name (Legal Business Name): JENNIFER SAECHAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PARKMOOR AVE
SAN JOSE CA
95126-3797
US

IV. Provider business mailing address

1400 PARKMOOR AVE
SAN JOSE CA
95126-3797
US

V. Phone/Fax

Practice location:
  • Phone: 408-971-9822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE3243192
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: