Healthcare Provider Details

I. General information

NPI: 1235091166
Provider Name (Legal Business Name): JENNIFER T DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18988 COX AVE STE B
SARATOGA CA
95070-4154
US

IV. Provider business mailing address

5790 BARNSWELL WAY
SAN JOSE CA
95138-1604
US

V. Phone/Fax

Practice location:
  • Phone: 408-253-4407
  • Fax: 408-253-4499
Mailing address:
  • Phone: 408-310-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: