Provider Demographics
NPI:1558406462
Name:CHEN, JANE W (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:W
Last Name:CHEN
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 1:106 PLACER OAKS CT
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3410
Mailing Address - Country:US
Mailing Address - Phone:408-858-8151
Mailing Address - Fax:302-338-6985
Practice Address - Street 1:2516 SAMARITAN DR STE J
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-858-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054942208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA208000000XOtherSPECIALTY LICENSE NUMBER
CAA054942OtherSTATE LICENSE NUMBER