Provider Demographics
NPI:1407080419
Name:JAFFE, COURTNEY E (RN, CNS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:JAFFE
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:E
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:275 HOSPITAL PKWY
Mailing Address - Street 2:SUITE 325
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1106
Mailing Address - Country:US
Mailing Address - Phone:408-972-6301
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002887363LG0600X, 363L00000X
CA3164364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology