MEDICARE: JACKIE JIN LIN

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1407559388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACKIE JIN LIN

Provider Business Mailing Address
First Line	:	300 PASTEUR DR
Second Line	:
City	:	STANFORD
State	:	CA
Zip	:	94305-2200
Country	:	US
Telephone Number	:	650-723-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 PARNASSUS AVE # M1480
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94143-2204
Country	:	US
Telephone Number	:	415-476-1528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2023
Last Update Date	:	06/17/2026

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Directions to “ JACKIE JIN LIN ” Practice Location

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