Provider Demographics
NPI:1831883453
Name:OWENS, COURTNEY JEANS (NP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:JEANS
Last Name:OWENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4283
Mailing Address - Country:US
Mailing Address - Phone:650-498-6500
Mailing Address - Fax:650-324-4816
Practice Address - Street 1:1300 CRANE ST
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4283
Practice Address - Country:US
Practice Address - Phone:650-498-6500
Practice Address - Fax:650-324-4816
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010945363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner