Healthcare Provider Details

I. General information

NPI: 1578666186
Provider Name (Legal Business Name): JENNIFER HELEN DOVICHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 111
SAN FRANCISCO CA
94118-1504
US

IV. Provider business mailing address

3 ALTARINDA ROAD SUITE 300
ORINDA CA
94563
US

V. Phone/Fax

Practice location:
  • Phone: 415-387-9293
  • Fax: 415-885-3738
Mailing address:
  • Phone: 925-254-9500
  • Fax: 925-254-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA66114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: