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NPI Code Detail

MEDICARE: JENNIFER MASON PHD

MEDICARE: JENNIFER MASON PHD
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
1103T00000XPsychologist27581CA

General Provider Information

NPI Number : 1598283517
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MASON PHD
Provider Business Mailing Address
First Line : 333 MAIN ST APT 328
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1773
Country : US
Telephone Number : 650-274-5446
Fax Number :
Provider Business Practice Location Address
First Line : 617 VETERANS BLVD STE 204
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1419
Country : US
Telephone Number : 650-477-6165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 08/30/2017

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