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General NPI Number Information
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NPI Number | 1053752386
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Entity Type | Individual
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Provider Name | KARLA JURVETSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 350 2ND ST STE 4
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City | LOS ALTOS
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State | CA
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Zip | 94022-3602
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Country | US
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Telephone | 650-941-9220
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Fax |
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Provider Business Mailing Address
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Address Line | 27200 ALTAMONT RD
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City | LOS ALTOS HILLS
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State | CA
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Zip | 94022-4227
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Country | US
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Telephone | 650-948-8355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G080068
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License Number State | CA
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