Provider Demographics
NPI:1750672010
Name:ABRAMS, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2979 WOODSIDE RD
Mailing Address - Street 2:THE VILLAGE DOCTOR
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2443
Mailing Address - Country:US
Mailing Address - Phone:650-851-4747
Mailing Address - Fax:650-851-4343
Practice Address - Street 1:2979 WOODSIDE RD
Practice Address - Street 2:THE VILLAGE DOCTOR
Practice Address - City:WOODSIDE
Practice Address - State:CA
Practice Address - Zip Code:94062
Practice Address - Country:US
Practice Address - Phone:650-851-4747
Practice Address - Fax:650-851-4343
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine