Healthcare Provider Details

I. General information

NPI: 1891128914
Provider Name (Legal Business Name): JENNA STARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 LUNDY AVE STE 223
SAN JOSE CA
95131-1887
US

IV. Provider business mailing address

814 INVERNESS WAY
SUNNYVALE CA
94087-4801
US

V. Phone/Fax

Practice location:
  • Phone: 408-284-9010
  • Fax:
Mailing address:
  • Phone: 408-910-4889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: