Provider Demographics
NPI:1932368560
Name:DEVIDO, JEFFREY J (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:J
Last Name:DEVIDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PARNASSUS AVE BOX 0984
Mailing Address - Street 2:UCSF, LANGLEY PORTER
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2211
Mailing Address - Country:US
Mailing Address - Phone:415-476-7716
Mailing Address - Fax:
Practice Address - Street 1:401 PARNASSUS AVE BOX 0984
Practice Address - Street 2:UCSF, LANGLEY PORTER
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2211
Practice Address - Country:US
Practice Address - Phone:415-476-7716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1267452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry