Provider Demographics
NPI:1417594078
Name:FAYE JENSEN M.D., INC.
Entity Type:Organization
Organization Name:FAYE JENSEN M.D., INC.
Other - Org Name:GRASS VALLEY WOMEN'S CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-272-9615
Mailing Address - Street 1:105 MARGARET LN
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5289
Mailing Address - Country:US
Mailing Address - Phone:530-272-9615
Mailing Address - Fax:
Practice Address - Street 1:105 MARGARET LN
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5289
Practice Address - Country:US
Practice Address - Phone:916-477-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty