Individual
JENNIE JET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1595 SOQUEL DR, STE 110, SANTA CRUZ, CA 95065-1719
(831) 462-9955
(831) 462-4488
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
(916) 379-2915
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G86051
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G860510
—
CA
Enumeration date
04/25/2006
Last updated
08/04/2014
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