Provider Demographics
NPI:1326494469
Name:YURIAR, JENNIFER ESTHER (NPA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ESTHER
Last Name:YURIAR
Suffix:
Gender:F
Credentials:NPA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:ESTHER
Other - Last Name:OTERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4413
Mailing Address - Country:US
Mailing Address - Phone:408-759-0312
Mailing Address - Fax:
Practice Address - Street 1:7475 CAMINO ARROYO
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7348
Practice Address - Country:US
Practice Address - Phone:408-852-2209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-08
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily