Provider Demographics
NPI:1184959033
Name:HAYASHI, JENNIFER HISAKO (PA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:HISAKO
Last Name:HAYASHI
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:301 LENNON LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2483
Mailing Address - Country:US
Mailing Address - Phone:925-932-9270
Mailing Address - Fax:925-932-9275
Practice Address - Street 1:301 LENNON LN
Practice Address - Street 2:SUITE 102
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2483
Practice Address - Country:US
Practice Address - Phone:925-932-9270
Practice Address - Fax:925-932-9275
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20498363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical