Provider Demographics
NPI:1700921079
Name:BRUNS, JENNIFER SUZANNE
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:BRUNS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:SUZANNE
Other - Last Name:DEEMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 DELAWARE ST APT 42
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1472
Mailing Address - Country:US
Mailing Address - Phone:510-981-0525
Mailing Address - Fax:
Practice Address - Street 1:1320 ARNOLD DR STE 160
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6537
Practice Address - Country:US
Practice Address - Phone:925-229-5400
Practice Address - Fax:925-229-5406
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other