Mose Alphonso Jennings, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA 12212 Issued in CA

Practice address

2425 Geary Blvd
San Francisco, CA 94115-3358

Phone

(415) 833-3800

NPI assigned

Dec 21, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427112317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 SEAGULL DR",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948047408",
            "telephone_number": "510-233-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 GEARY BLVD",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153358",
            "telephone_number": "415-833-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "MOSE",
        "middle_name": "ALPHONSO",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA 12212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Katz, Inc
• Jennifer Wong, O.D., Inc.
• Caden Jennings
• Kayla Jane Jennings, LMFT
• Melissa Jennings
• Susan Jennings, RDLD
• Thomas Jennings
• Tia N Jennings
• Jenny Wong, DDS Inc
• Christopher J Jenny, PA-C

• Surgical Physician Assistant in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.