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General NPI Number Information
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NPI Number | 1235285701
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Entity Type | Individual
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Provider Name | JENNI R. JESPERSEN MA, ATC
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 DIVISADERO ST SUITE 420
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0001
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Country | US
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Telephone | 415-353-7966
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 NUTHATCH LN
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City | SUNNYVALE
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State | CA
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Zip | 94087-4939
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Country | US
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Telephone | 408-718-4740
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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