Provider Demographics
NPI:1306045869
Name:WEBB, JENIFER EMMIE LAILA (OD)
Entity Type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:EMMIE LAILA
Last Name:WEBB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENIFER
Other - Middle Name:EMMIE LAILA
Other - Last Name:SEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1150 W EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2518
Mailing Address - Country:US
Mailing Address - Phone:650-967-5789
Mailing Address - Fax:650-967-4106
Practice Address - Street 1:1150 W EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2518
Practice Address - Country:US
Practice Address - Phone:650-967-5789
Practice Address - Fax:650-967-4106
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-15
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13313152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist