Provider Demographics
NPI:1154080588
Name:HARRIS, JANEL NADIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANEL
Middle Name:NADIA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24147 AMARANTH LOOP
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-6703
Mailing Address - Country:US
Mailing Address - Phone:408-693-0174
Mailing Address - Fax:
Practice Address - Street 1:6066 CIVIC TERRACE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-3746
Practice Address - Country:US
Practice Address - Phone:510-505-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA822207163WC0200X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine