Individual
JENNIFER M VAN WARMERDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 SHRADER ST, SUITE 650, SAN FRANCISCO, CA 94117-1016
(415) 221-0665
(415) 221-0687
Mailing address
3400 DATA DR, ATTN CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A96120
CA
Other
Enumeration date
05/12/2009
Last updated
09/08/2023
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