Basic Information
Provider Information
NPI: 1124639570
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAIMO
FirstName: JENNIFER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RADT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1060 HIGHLAND CT APT 15
Address2:  
City: SANTA CLARA
State: CA
PostalCode: 950507100
CountryCode: US
TelephoneNumber: 4085043010
FaxNumber:  
Practice Location
Address1: 2001 THE ALAMEDA
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951261136
CountryCode: US
TelephoneNumber: 4082617777
FaxNumber: 4082592273
Other Information
ProviderEnumerationDate: 08/10/2020
LastUpdateDate: 08/10/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/10/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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