Basic Information
| Provider Information | |||||||||
| NPI: | 1710191820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JENSEN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 STANYAN ST. | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156804135 | ||||||||
| FaxNumber: | 4155205153 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 STANYAN ST. | ||||||||
| Address2: | ROOM 503 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157505909 | ||||||||
| FaxNumber: | 4157505910 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 10/28/2019 | ||||||||
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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 | 208M00000X | 20A9962 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 20A9962 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.