Provider Demographics
NPI:1174320022
Name:RADIANT WOMENS HEALTH - PALO ALTO INC
Entity type:Organization
Organization Name:RADIANT WOMENS HEALTH - PALO ALTO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-504-0294
Mailing Address - Street 1:3749 BUCHANAN ST # 475054
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-1710
Mailing Address - Country:US
Mailing Address - Phone:650-585-3272
Mailing Address - Fax:650-860-1830
Practice Address - Street 1:150 PORTOLA RD STE A
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7852
Practice Address - Country:US
Practice Address - Phone:650-585-3272
Practice Address - Fax:650-860-1830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty