Individual provider Active NPI

Jennie Liebermann, RN

  • School Registered Nurse
  • San Jose, CA
National Provider Identifier
1497663728
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
95408971 Issued in CA
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

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.