| NPI | 1447057526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JENSEN Owner/Employee 408-627-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2025-02-26 |
| Last Update Date | 2025-04-11 |