Healthcare Provider Details

I. General information

NPI: 1811052368
Provider Name (Legal Business Name): JESSICA KAPLAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 24TH ST NOE VALLEY PEDIATRICS
SAN FRANCISCO CA
94114-3904
US

IV. Provider business mailing address

1526 FRANCISCO ST APT 1
SAN FRANCISCO CA
94123-2292
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-1019
  • Fax: 415-826-1308
Mailing address:
  • Phone: 415-931-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberA051657
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: