=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295641611
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMIE RANKIN PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2026
-----------------------------------------------------
Last Update Date | 08/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 25 EDWARDS CT STE 101
-----------------------------------------------------
City | BURLINGAME
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94010-2421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 416-857-1151
-----------------------------------------------------
Fax | 650-727-0551
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4382 OTHELLO DR
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94555-2028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 95041203
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------