Provider Demographics
NPI:1144764242
Name:LOW, JENNIFER (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LOW
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39350 CIVIC CENTER DR #300
Mailing Address - Street 2:
Mailing Address - City:FREEMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2331
Mailing Address - Country:US
Mailing Address - Phone:510-797-3933
Mailing Address - Fax:510-797-5164
Practice Address - Street 1:39350 CIVIC CENTER DR #300
Practice Address - Street 2:
Practice Address - City:FREEMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2331
Practice Address - Country:US
Practice Address - Phone:510-797-3933
Practice Address - Fax:510-797-5164
Is Sole Proprietor?:No
Enumeration Date:2016-12-07
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025463163W00000X
CA95005068363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health