Larsen, Jennifer Jean Nissly

Larsen, Jennifer Jean Nissly is an individual health care provider with primary practice located at 1200 El Camino Real Dept 384 , South San Francisco CA 94080-3208. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Larsen, Jennifer Jean Nissly can be contacted via phone (650) 742-2000.

Contact Information

Primary practice address
1200 El Camino Real Dept 384 South San Francisco CA 94080-3208
Phone: (650) 742-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A122827 California
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1578839486
LBN Legal business name Larsen, Jennifer Jean Nissly
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2012
Last updated Jan 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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