Active NPI
Jennie Liebermann, RN
- School Registered Nurse
- San Jose, CA
National Provider Identifier
1497663728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 95408971
- Practice address
- 830 N Capitol Ave
San Jose, CA 95133-1316 - Phone
- (408) 917-8818
- Fax
- (408) 347-5526
- NPI assigned
- Aug 28, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 95408971 | CA | Primary |
Addresses
Primary practice location
830 N Capitol Ave
San Jose, CA 95133-1316
Mailing address
612 S El Camino Real Apt 2
San Mateo, CA 94402-1712
Phone (408) 917-8183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1497663728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 S EL CAMINO REAL APT 2",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944021712",
"telephone_number": "408-917-8183",
"fax_number": "408-347-5526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 N CAPITOL AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951331316",
"telephone_number": "408-917-8818",
"fax_number": "408-347-5526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMANN",
"first_name": "JENNIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-08-28",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "CA",
"license": "95408971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.