Provider Demographics
NPI:1285061952
Name:FICK, JENNIFER HELEN (FNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HELEN
Last Name:FICK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:HELEN
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN
Mailing Address - Street 1:450 SUTTER ST RM 1520
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4011
Mailing Address - Country:US
Mailing Address - Phone:415-624-3922
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 1520
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4011
Practice Address - Country:US
Practice Address - Phone:415-624-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505685163W00000X
CA95005782363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse