Healthcare Provider Details

I. General information

NPI: 1447154174
Provider Name (Legal Business Name): JENNY CHU
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S EL CAMINO REAL STE 300
SAN MATEO CA
94402-3063
US

IV. Provider business mailing address

2916 REQUA CT
SAN JOSE CA
95148-2754
US

V. Phone/Fax

Practice location:
  • Phone: 650-458-0026
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: