Provider Demographics
NPI:1962768374
Name:JASWA, ELENI ANNE (MD, MSC)
Entity type:Individual
Prefix:DR
First Name:ELENI
Middle Name:ANNE
Last Name:JASWA
Suffix:
Gender:F
Credentials:MD, MSC
Other - Prefix:
Other - First Name:ELENI
Other - Middle Name:ANNE
Other - Last Name:GREENWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MSC
Mailing Address - Street 1:2995 WOODSIDE RD
Mailing Address - Street 2:STE 400
Mailing Address - City:WOODSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:94062
Mailing Address - Country:US
Mailing Address - Phone:612-201-8532
Mailing Address - Fax:
Practice Address - Street 1:499 ILLINOIS ST FL 6
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2518
Practice Address - Country:US
Practice Address - Phone:415-353-7475
Practice Address - Fax:415-353-7744
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA129641207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RES000Medicare UPIN