Healthcare Provider Details

I. General information

NPI: 1619321304
Provider Name (Legal Business Name): JENNIFER CHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2016
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 JACKSON ST # B1
SAN FRANCISCO CA
94133-4851
US

IV. Provider business mailing address

845 JACKSON ST # B1
SAN FRANCISCO CA
94133-4851
US

V. Phone/Fax

Practice location:
  • Phone: 415-677-2370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA164480
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: