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General NPI Number Information
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NPI Number | 1497663728
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Entity Type | Individual
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Provider Name | JENNIE LIEBERMANN RN
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Gender |
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 830 N CAPITOL AVE
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City | SAN JOSE
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State | CA
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Zip | 95133-1316
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Country | US
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Telephone | 408-917-8818
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Fax | 408-347-5526
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Provider Business Mailing Address
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Address Line | 612 S EL CAMINO REAL APT 2
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City | SAN MATEO
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State | CA
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Zip | 94402-1712
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Country | US
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Telephone | 408-917-8183
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Fax | 408-347-5526
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 95408971
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License Number State | CA
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