Provider Demographics
NPI:1497407241
Name:WU, JINGSHAN
Entity Type:Individual
Prefix:
First Name:JINGSHAN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1101
Mailing Address - Country:US
Mailing Address - Phone:415-753-7400
Mailing Address - Fax:
Practice Address - Street 1:1990 41ST AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1101
Practice Address - Country:US
Practice Address - Phone:415-753-7400
Practice Address - Fax:415-753-0164
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker