Provider Demographics
NPI:1255868071
Name:MORAY, JENNIFER
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:MORAY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:PAVINI
Other - Middle Name:
Other - Last Name:MORAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:108 LAPHAM WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4538
Mailing Address - Country:US
Mailing Address - Phone:510-333-2098
Mailing Address - Fax:
Practice Address - Street 1:3490 20TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2582
Practice Address - Country:US
Practice Address - Phone:415-562-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator