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General NPI Number Information
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NPI Number | 1720961956
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Entity Type | Individual
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Provider Name | JENNIFER DIEM LAM
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 1380 HOWARD ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-2638
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Country | US
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Telephone | 628-754-9110
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Fax |
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Provider Business Mailing Address
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Address Line | 129 PEONY CT
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City | FREMONT
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State | CA
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Zip | 94538-2425
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Country | US
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Telephone | 510-378-9271
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | CA
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