Provider Demographics
NPI:1447267414
Name:HUNTER, JANE EMILY (MD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:EMILY
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:EMILY
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2320 WOOSLEY STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705
Mailing Address - Country:US
Mailing Address - Phone:510-849-1744
Mailing Address - Fax:510-849-0326
Practice Address - Street 1:2320 WOOSLEY STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-849-1744
Practice Address - Fax:510-849-0326
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41508208000000X
ORMD18682208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G415080Medicaid