Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E2833 | CA |
Y | 222Z00000X | Podiatrist | E2833 | CA |
N | 213ES0131X | Foot Surgery | E2833 | CA |
NPI | 1144223793 |
---|---|
Provider Name | Dr. Steve Christian Jensen |
First Address | Sonora, CA 95370-5223 |
Second Address | Sonora, CA 95370-5223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 08/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E28330 | (05) | CA |
T11489 | (02) |