Jacqueline Tom Jew, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN302387 Issued in CA

Practice address

3260 Kerner Blvd
San Rafael, CA 94901-4861

Phone

(415) 473-6338

Fax

(415) 473-2179

NPI assigned

Mar 13, 2009

Last updated

Mar 13, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marin County Health and Human Services

  dba Marin County Immunization Clinic

  • Public Health or Welfare Agency
  • San Rafael, CA
  • NPI 1366688434
  NPD (past)

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1548401953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 NORTHGATE DR STE 100",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033664",
            "telephone_number": "415-473-6338",
            "fax_number": "415-473-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014861",
            "telephone_number": "415-473-6338",
            "fax_number": "415-473-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEW",
        "first_name": "JACQUELINE",
        "middle_name": "TOM",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN302387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Jenkins, PSYD
• Kimberly Ann Jenkinson
• Jennea R Wood (Aralia Natural Medicine)
• Cindy Jepsen
• Timothy Jergesen
• Jewish Family and Children's Services
• Jewish Family and Children's Services
• Jewish Family and Children's Services
• Jewish Family and Childrens Services
• Shuai Jiang, DPT

• Registered Nurse in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.