Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A143349 | CA |
Y | 2084N0402X | Child Neurologist | A143349 | CA |
NPI | 1104116292 |
---|---|
Provider Name | Dr. Jennifer A O'malley |
First Address | Palo Alto, CA 94304-1601 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2011 |
Last Update Date | 10/10/2019 |