Provider Demographics
NPI:1235799032
Name:KURU, JENNA LYNN BELOBRAIDIC (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN BELOBRAIDIC
Last Name:KURU
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S BASCOM AVE STE 2005
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3538
Mailing Address - Country:US
Mailing Address - Phone:510-859-8082
Mailing Address - Fax:510-275-1162
Practice Address - Street 1:1460 MARIA LN STE 300
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5314
Practice Address - Country:US
Practice Address - Phone:510-859-8082
Practice Address - Fax:510-275-1162
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011989363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health