Provider Demographics
NPI:1477866747
Name:COHN, JENNIFER AMICA (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AMICA
Last Name:COHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 DIAMOND STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-9411
Mailing Address - Country:US
Mailing Address - Phone:718-208-3123
Mailing Address - Fax:
Practice Address - Street 1:450 SERRA MALL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94305-2004
Practice Address - Country:US
Practice Address - Phone:650-723-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110257208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation