1093908766 NPI number — JANIE ANN SALAZAR APRN, FNP, MSN, PHN

Table of content: JANIE ANN SALAZAR APRN, FNP, MSN, PHN (NPI 1093908766)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093908766 NPI number — JANIE ANN SALAZAR APRN, FNP, MSN, PHN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SALAZAR
Provider First Name:
JANIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP, MSN, PHN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OLSEN
Provider Other First Name:
JANE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN, BSN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093908766
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9300 VALLEY CHILDRENS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADERA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93636-8761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-353-6022
Provider Business Mailing Address Fax Number:
559-353-7176

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9300 VALLEY CHILDRENS PL
Provider Second Line Business Practice Location Address:
MOB-CHILD ADVOCACY CLINIC SUITE 105
Provider Business Practice Location Address City Name:
MADERA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93636-8761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-353-6022
Provider Business Practice Location Address Fax Number:
559-353-7176
Provider Enumeration Date:
08/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QM1102X , with the licence number:  APRN-967 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM2500X , with the licence number: 376865 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: APRN-967 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 15456 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)