Provider Demographics
NPI:1568018075
Name:HERMES, JET
Entity Type:Individual
Prefix:DR
First Name:JET
Middle Name:
Last Name:HERMES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ZILI
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:509 TOWER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136-3733
Mailing Address - Country:US
Mailing Address - Phone:628-529-7812
Mailing Address - Fax:
Practice Address - Street 1:2672 MARINE WAY
Practice Address - Street 2:SUITE 1045
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043
Practice Address - Country:US
Practice Address - Phone:408-905-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027014390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program