Provider Demographics
NPI:1619434628
Name:CHOU, JEFFREY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:CHOU
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 FORBES BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-2026
Mailing Address - Country:US
Mailing Address - Phone:650-624-9188
Mailing Address - Fax:
Practice Address - Street 1:400 PARNASSUS AVE FL 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-2200
Practice Address - Fax:415-353-2641
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95010451363LA2100X
CA95010451363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care