Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3725 | CA |
Y | 222Z00000X | Podiatrist | E3725 | CA |
NPI | 1043214869 |
---|---|
Provider Name | Dr. Jennifer Sanders |
First Address | San Francisco, CA 94104-3907 |
Second Address | San Francisco, CA 94104-3907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 17/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U08681 | (02) | CA |