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General NPI Number Information
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NPI Number | 1821129818
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Entity Type | Individual
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Provider Name | JENNIFER N DESPRES CNM, NP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 975 SERENO DR
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City | VALLEJO
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State | CA
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Zip | 94589-2441
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Country | US
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Telephone | 707-651-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1731 COLEMAN ST
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City | NAPA
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State | CA
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Zip | 94559-1724
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Country | US
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Telephone | 707-254-7935
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW1701
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License Number State | CA
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