Provider Demographics
NPI:1013006998
Name:JAVERBAUM, JEFFREY STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:STEPHEN
Last Name:JAVERBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:695 OAK GROVE AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025
Mailing Address - Country:US
Mailing Address - Phone:650-324-0700
Mailing Address - Fax:650-324-0709
Practice Address - Street 1:695 OAK GROVE AVE
Practice Address - Street 2:STE 310
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025
Practice Address - Country:US
Practice Address - Phone:650-324-0700
Practice Address - Fax:650-324-0709
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-10-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG0336822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology