MEDICARE: JENN KEYS L.AC.

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	171100000X	Acupuncturist	CA9198	CA

General Provider Information

NPI Number	:	1639245426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENN KEYS L.AC.

Provider Business Mailing Address
First Line	:	1105 PALOMA AVE APT 3
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3540
Country	:	US
Telephone Number	:	415-205-4499
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 N SAN MATEO DR STE B
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94401-2609
Country	:	US
Telephone Number	:	415-205-4499
Fax Number	:

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

Provider Enumeration Date	:	11/26/2006
Last Update Date	:	06/09/2022

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