Provider Demographics
NPI:1417145343
Name:TUCKER, JENNIFER A (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:TUCKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:ECKENHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:6060 HELLYER AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1046
Mailing Address - Country:US
Mailing Address - Phone:408-227-6300
Mailing Address - Fax:408-227-6314
Practice Address - Street 1:6060 HELLYER AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1046
Practice Address - Country:US
Practice Address - Phone:408-227-6300
Practice Address - Fax:408-227-6314
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4836231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist