Jennie Jet, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

G86051 Issued in CA

Practice address

1595 Soquel Dr
Ste 110
Santa Cruz, CA 95065-1719

Phone

(831) 462-9955

Fax

(831) 462-4488

NPI assigned

Apr 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1073579231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956",
            "telephone_number": "916-379-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SOQUEL DR",
            "address_2": "STE 110",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651719",
            "telephone_number": "831-462-9955",
            "fax_number": "831-462-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JET",
        "first_name": "JENNIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G86051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G860510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kalonia Jennings
• Kaitlin Jensen
• Lisa Helen Jensen, MFCC
• Alexander Reed Jeremiah
• Amelia Jester, PMHNP
• Andrew Jiang
• Wei Jiang
• Elisa Jimenez
• Esmeralda Jimenez
• Jaime Manuel Jimenez, PMHNP-BC

• Physical Medicine & Rehabilitation Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.