Provider Demographics
NPI:1568684371
Name:HOSSAIN, JENNIFER ANN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:HOSSAIN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 ADELANTO LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1059
Mailing Address - Country:US
Mailing Address - Phone:408-274-7101
Mailing Address - Fax:
Practice Address - Street 1:3110 OAK LEAF CT
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-6702
Practice Address - Country:US
Practice Address - Phone:408-779-1652
Practice Address - Fax:408-779-1656
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT24804225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist