Provider Demographics
NPI:1396947875
Name:MOSS, JENNIFER LEIGH (MS, LAC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:MOSS
Suffix:
Gender:F
Credentials:MS, LAC
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Mailing Address - Street 1:3352B SACRAMENTO ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1912
Mailing Address - Country:US
Mailing Address - Phone:415-244-4412
Mailing Address - Fax:415-292-6730
Practice Address - Street 1:3352B SACRAMENTO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1912
Practice Address - Country:US
Practice Address - Phone:415-244-4412
Practice Address - Fax:415-292-6730
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC8239171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist