Healthcare Provider Details

I. General information

NPI: 1407135957
Provider Name (Legal Business Name): JESSICA ANN CAPRETTO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ANN ADAMCZAK PA-C

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 NORTHGATE DR
SAN RAFAEL CA
94903-2502
US

IV. Provider business mailing address

1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone: 415-658-6791
  • Fax: 415-520-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number58314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: