Provider Demographics
NPI:1356491112
Name:KWOCK, JAREMY LOWE (PA-C, MSPAS, MPH)
Entity Type:Individual
Prefix:MR
First Name:JAREMY
Middle Name:LOWE
Last Name:KWOCK
Suffix:
Gender:M
Credentials:PA-C, MSPAS, MPH
Other - Prefix:
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Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:925-884-2360
Mailing Address - Fax:925-779-3705
Practice Address - Street 1:20055 LAKE CHABOT RD STE 110
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5332
Practice Address - Country:US
Practice Address - Phone:925-884-2360
Practice Address - Fax:925-779-3705
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA18553363A00000X
FLPA9116669363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant