Provider Demographics
NPI:1538236112
Name:JENSEN, WILLIAM (LPT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 MARKET ST
Mailing Address - Street 2:4TH FL
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1706
Mailing Address - Country:US
Mailing Address - Phone:415-597-8010
Mailing Address - Fax:
Practice Address - Street 1:939 MARKET ST
Practice Address - Street 2:4TH FL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1706
Practice Address - Country:US
Practice Address - Phone:415-597-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 14293167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician