Basic Information
| Provider Information | |||||||||
| NPI: | 1194123653 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEWARD | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | V | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1510 4TH ST 1 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947101717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105258980 | ||||||||
| FaxNumber: | 5105258982 | ||||||||
| Practice Location | |||||||||
| Address1: | 2459 PACHECO ST | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945202019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5056998978 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2014 | ||||||||
| LastUpdateDate: | 08/06/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 95002088 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.