Most Relevant Information
Provider Data
| NPI Number: | 1003596743 |
| Provider Name: | JENNIFER FAN |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 29840 |
Most Important Dates
| Enumeration Date: | 07/18/2023 |
| Last Updated: | 07/18/2023 |
Provider Practice Location
3924 RESTON CT
SOUTH SAN FRANCISCO
CA
940803946
Practice Location Phone/Fax
| Phone: | 4154088281 |
| Fax: |
Provider Mailing Location
3924 RESTON CT
SOUTH SAN FRANCISCO
CA
940803946
Provider Mailing Phone/Fax
| Phone: | 4154088281 |
| Fax: |