Individual provider · Type 1 NPI

Jerry Shen

Student in an Organized Health Care Education/Training Program · Sylmar, CA

NPI number 1609571512 Active

Practice location

14445 Olive View Drive, Dept. Of Medicine, Rm. 2B182
Sylmar, CA 91342

Call (747) 210-3205 Map

Mailing address

1559 Carnavon Way
San Jose, CA 95131-2482

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1609571512

Jerry Shen's National Provider Identifier is 1609571512, issued on Mar 31, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Sylmar, CA. The record was last updated on Mar 21, 2024.