1912940818 NPI number — DR. JENNIFER ELIZABETH BOYD PHD

Table of content: DR. JENNIFER ELIZABETH BOYD PHD (NPI 1912940818)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912940818 NPI number — DR. JENNIFER ELIZABETH BOYD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOYD
Provider First Name:
JENNIFER
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RITSHER
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
BOYD
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912940818
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4150 CLEMENT ST
Provider Second Line Business Mailing Address:
PSYCHIATRY (116A)
Provider Business Mailing Address City Name:
SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94121-1545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
415-221-4810
Provider Business Mailing Address Fax Number:
415-668-7503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 BUSH ST
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94109-5239
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-572-5838
Provider Business Practice Location Address Fax Number:
415-668-7503
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSY17753 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)