Provider Demographics
NPI:1205503893
Name:HOPPE-KEISER, JESSLYNN
Entity type:Individual
Prefix:
First Name:JESSLYNN
Middle Name:
Last Name:HOPPE-KEISER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 DELTA DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3709
Mailing Address - Country:US
Mailing Address - Phone:669-239-5046
Mailing Address - Fax:
Practice Address - Street 1:8300 DELTA DR UNIT A
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3709
Practice Address - Country:US
Practice Address - Phone:669-239-5046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker