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General NPI Number Information
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NPI Number | 1205169570
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Entity Type | Individual
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Provider Name | JAMIE RO PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 39650 LIBERTY ST. STE #300, FL3
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City | FREMONT
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State | CA
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Zip | 94538-2227
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Country | US
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Telephone | 510-498-2689
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Fax |
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Provider Business Mailing Address
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Address Line | 2350 W. EL CAMINO REAL 2ND FLOOR
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City | MOUNATIN VIEW
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State | CA
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Zip | 94040-6203
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Country | US
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Telephone |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA53413
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License Number State | CA
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