Kristine L. Jessen-Mather, NP #NPF4647

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP 4647 Issued in CA

Practice address

140 Litton Dr. #100
Grass Valley, CA 95945

Phone

(530) 477-4016

Fax

(530) 477-4018

NPI assigned

Sep 17, 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

Other names 1

• Ms. Kris L. Jessen-Mather Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1942307673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LITTON DR. #100",
            "address_2": "PO BOX 459001",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-477-4016",
            "fax_number": "530-477-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LITTON DR. #100",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "95945",
            "telephone_number": "530-477-4016",
            "fax_number": "530-477-4018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN-MATHER",
        "first_name": "KRISTINE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NP #NPF4647",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP 4647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACT. CERTIFICATIO",
            "identifier": "NP 4647",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRIS",
            "last_name": "JESSEN-MATHER",
            "middle_name": "L.",
            "prefix": "MS.",
            "credential": "NP #NPF4647",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Heather Lyn Jensen
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• Justin David Jensen
• Michael Lawrence Jensen, D.O.
• Jeremy M Young DDS MMSC Inc
• Laurie Jessup
• Michelle Jodoin
• John H. Stewart
• John W. Lace, M.D., Inc.
• Richard Lance Johns

• Pediatric Nurse Practitioner in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.