| Doctor Name: | MRS. JEANNOT LEE CARLSON |
| NPI Number: | 1104036474 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 209664 |
| Business Practice Address: | 599 Sir Francis Drake Blvd Ste 202 Suite 117 Greenbrae, CA - 949041731 |
| Business Phone Number: | 4154611149 |
| Business Fax Number: | 4159251156 |
| Mailing Address: | 599 Sir Francis Drake Blvd Ste 202, Suite 117 GREENBRAE |
| State: | CA |
| Postal Code: | 949041731 |
| Phone Number: | 4154611149 |
| Fax Number: | 4159251156 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 02/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 209664 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |