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1215458120
JENNA DERICKSON
OAKLAND, CA
NPI
1215458120
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 54296)
Enumeration Date
2017-06-30
Last Update Date
2022-01-03
Business Address
JENNA DERICKSON
275 W MACARTHUR BLVD
OAKLAND, CA 94611-5641
Phone number: 510-752-1105
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Mailing Address
JENNA DERICKSON
275 W MACARTHUR BLVD FL 3
OAKLAND, CA 94611-5641
Phone number: 510-752-1105
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