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General NPI Number Information
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NPI Number | 1235799032
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Entity Type | Individual
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Provider Name | JENNA LYNN BELOBRAIDIC KURU PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2019
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1460 MARIA LN STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94596-5314
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Country | US
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Telephone | 510-859-8082
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Fax | 510-275-1162
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Provider Business Mailing Address
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Address Line | 950 S BASCOM AVE STE 2005
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City | SAN JOSE
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State | CA
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Zip | 95128-3538
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Country | US
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Telephone | 510-859-8082
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Fax | 510-275-1162
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95011989
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License Number State | CA
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