Jet, Jennie

Jet, Jennie is an individual health care provider with primary practice located at 1595 Soquel Dr Ste 110, Santa Cruz CA 95065-1719. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Jet, Jennie can be contacted via phone (831) 462-9955.

Contact Information

Primary practice address
1595 Soquel Dr Ste 110 Santa Cruz CA 95065-1719
Phone: (831) 462-9955
Fax: (831) 462-4488
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X G86051 California

Profile Details

NPI number 1073579231
LBN Legal business name Jet, Jennie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Aug 4th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073579231 NPPES
California MEDICAID 00G860510

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