Jennifer Rebecca Malloy, PA-C
Physician Assistant, Surgical in Campbell, CA. Individual provider (NPI-1).
NPI number1114008554
StatusActive
Last updated in NPPESFeb 26, 2010
Details
- NPI
- 1114008554
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jennifer Rebecca Malloy
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 18, 2006
- Last updated
- Feb 26, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | PA17849 | CA | Yes |
Practice location
2255 S Bascom AveSuite 200
Campbell, CA 95008-7800
Phone 408-376-3626 · Fax 408-871-2377
Mailing address
2255 S Bascom AveSuite 200
Campbell, CA 95008-7800
Phone 408-376-3626 · Fax 408-871-2377
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