Provider Demographics
NPI:1295053718
Name:ZISKIN, JENNIFER (MD, PHD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ZISKIN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MARSHALL ST
Mailing Address - Street 2:MARSHALL BUILDING 4TH
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2026
Mailing Address - Country:US
Mailing Address - Phone:650-299-3218
Mailing Address - Fax:650-299-2301
Practice Address - Street 1:901 MARSHALL ST BLDG 4TH
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2026
Practice Address - Country:US
Practice Address - Phone:650-299-3218
Practice Address - Fax:650-299-2301
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117752207ZN0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology