Healthcare Provider Details

I. General information

NPI: 1023509882
Provider Name (Legal Business Name): JESSICA KENSER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2018
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 1ST ST STE A
SAN FRANCISCO CA
94105-2661
US

IV. Provider business mailing address

16777 W HAYLEY WAY # MS 21110Q
GOODYEAR AZ
85338-1405
US

V. Phone/Fax

Practice location:
  • Phone: 888-803-3370
  • Fax:
Mailing address:
  • Phone: 480-262-7420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number207608-7
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: