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Individual

MR. JEREMY JAYME GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN, MSN, NP-C

Contact information

Practice address
1100 S ELISEO DR STE 1, GREENBRAE, CA 94904
(415) 514-5000
(415) 502-5550
Mailing address
8 LOCKSLEY AVE APT 7F, SAN FRANCISCO, CA 94122-3849
(609) 674-8193
(415) 502-5550

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR14301200
NJ
163W00000X
Registered Nurse
829229
CA
163W00000X
Registered Nurse
RN601208
PA
363L00000X
Nurse Practitioner
Primary
22686
CA
363LF0000X
Family Nurse Practitioner
22686
CA

Other

Enumeration date
06/13/2012
Last updated
10/09/2018
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