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NPI Code Detail

MEDICARE: JACQUELYN LOWMAN

MEDICARE: JACQUELYN LOWMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCA
2363LF0000XFamily Nurse Practitioner95015293CA

General Provider Information

NPI Number : 1235553173
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN LOWMAN
Provider Business Mailing Address
First Line : 250 BRANDON ST APT 124
Second Line :
City : SAN JOSE
State : CA
Zip : 95134-3441
Country : US
Telephone Number : 213-718-2269
Fax Number :
Provider Business Practice Location Address
First Line : 2514 BERRYESSA RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95132-2947
Country : US
Telephone Number : 408-272-1431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2014
Last Update Date : 05/08/2023

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