| Doctor Name: | JENNIFER TOM SHIPP |
| NPI Number: | 1245331271 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 321752 |
| Business Practice Address: | 6800 Palm Ave Suite C Sebastopol, CA - 954724269 |
| Business Phone Number: | 7078249999 |
| Business Fax Number: | 7078249329 |
| Mailing Address: | Po Box 1449, GUERNEVILLE |
| State: | CA |
| Postal Code: | 954461449 |
| Phone Number: | 7078695977 |
| Fax Number: | 7078695983 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 12/27/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 321752 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |