Individual
DR. ANTOINETTE JENNA MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
34 MARK WEST SPRINGS RD, SANTA ROSA, CA 95403-1766
(707) 303-3600
(707) 303-3611
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(707) 303-3600
(707) 303-3611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1243745
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A164014
STATE MEDICAL LICENSE
CA
Enumeration date
03/31/2018
Last updated
04/25/2023
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