Provider Demographics
NPI:1164287538
Name:SY, JENNIFER MARIEZEHL (CNIM)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIEZEHL
Last Name:SY
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 103631
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-0001
Mailing Address - Country:US
Mailing Address - Phone:213-784-7614
Mailing Address - Fax:
Practice Address - Street 1:3863 SHERWOOD PL
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-4607
Practice Address - Country:US
Practice Address - Phone:213-784-7614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic