Individual
JENNIFER STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
645 WOOL CREEK DR, SAN JOSE, CA 95112-2617
(408) 283-6051
(408) 283-6210
Mailing address
5671 SANTA TERESA BLVD, SUITE 105, SAN JOSE, CA 95123-6512
(408) 284-2280
(408) 281-2857
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
19133
CA
Other
Enumeration date
06/07/2010
Last updated
06/07/2010
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