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General NPI Number Information
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NPI Number | 1497054639
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Entity Type | Individual
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Provider Name | JENNIFER REBECCA ALBON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2011
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 815 E 15TH ST PEDIATRIC CENTER OF EXCELLENCE
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City | DOUGLAS
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State | AZ
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Zip | 85607-1631
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Country | US
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Telephone | 520-364-5437
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Fax | 520-364-4261
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Provider Business Mailing Address
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Address Line | 505 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2204
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Country | US
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Telephone | 520-364-1429
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Fax | 520-364-4261
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | RESIDENT
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A149072
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 48927
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License Number State | AZ
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