Provider Demographics
NPI:1457333189
Name:JAFFE, JILL F (NP)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:F
Last Name:JAFFE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 FRANKLIN ST
Mailing Address - Street 2:WHRI, 19TH FLOOR, KAISER PERMANENTE
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-5103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1950 FRANKLIN ST
Practice Address - Street 2:WHRI, 19TH FLOOR, KAISER PERMANENTE
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-5103
Practice Address - Country:US
Practice Address - Phone:510-987-3857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308404363LW0102X, 363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN308404OtherMEDI-CAL PROVIDER #
CARN308404OtherMEDI-CAL PROVIDER #