Provider Demographics
NPI:1932270485
Name:SUGDEN, JENNIFER G (ND)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:G
Last Name:SUGDEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1098 FOSTER CITY BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-2375
Mailing Address - Country:US
Mailing Address - Phone:650-474-2130
Mailing Address - Fax:650-445-0912
Practice Address - Street 1:1098 FOSTER CITY BLVD STE 305
Practice Address - Street 2:
Practice Address - City:FOSTER CITY
Practice Address - State:CA
Practice Address - Zip Code:94404-2375
Practice Address - Country:US
Practice Address - Phone:650-474-2130
Practice Address - Fax:650-445-0912
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1352175F00000X
CAND-537175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR20-1832726OtherTAX ID