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NPI Code Detail

MEDICARE: JENNIFER L BETTS MD

MEDICARE: JENNIFER L BETTS MD
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
1207Q00000XFamily Medicine PhysicianA72470CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518965771
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L BETTS MD
Provider Business Mailing Address
First Line : 144 STONY POINT RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4122
Country : US
Telephone Number : 707-521-4541
Fax Number : 707-544-4626
Provider Business Practice Location Address
First Line : 144 STONY POINT RD
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-4122
Country : US
Telephone Number : 707-521-4541
Fax Number : 707-544-4626
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 02/16/2024

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