Provider Demographics
NPI:1063643179
Name:EBERLEIN, JANE KATHRYN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:KATHRYN
Last Name:EBERLEIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1940 5TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2364
Mailing Address - Country:US
Mailing Address - Phone:619-683-2820
Mailing Address - Fax:619-683-2825
Practice Address - Street 1:2918 5TH AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103
Practice Address - Country:US
Practice Address - Phone:619-683-2820
Practice Address - Fax:619-683-2825
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA9311363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily