Provider Demographics
NPI:1144523226
Name:VINER, JENNIFER AMY (NP)
Entity type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:AMY
Last Name:VINER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 HYDE ST
Mailing Address - Street 2:APT 5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3197
Mailing Address - Country:US
Mailing Address - Phone:415-699-2862
Mailing Address - Fax:415-353-2889
Practice Address - Street 1:400 PARNASSUS AVE
Practice Address - Street 2:SUITE A808
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2202
Practice Address - Country:US
Practice Address - Phone:415-353-2361
Practice Address - Fax:415-353-2889
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19084363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner