Provider Demographics
NPI:1225239684
Name:BRENNAN, JESSICA LOWE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LOWE
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:JERMANE
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:119 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2607
Mailing Address - Country:US
Mailing Address - Phone:415-473-2423
Mailing Address - Fax:415-476-9976
Practice Address - Street 1:117 PARKER AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2607
Practice Address - Country:US
Practice Address - Phone:415-473-2423
Practice Address - Fax:415-476-9976
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15126363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics