Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A16827 | CA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 20A16827 | CA |
NPI | 1164670550 |
---|---|
Provider Name | Dr. Jessica Raelynn Zarndt |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Santa Monica, CA 90404-3414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2008 |
Last Update Date | 25/11/2019 |