Provider Demographics
NPI:1235209131
Name:WASKO, JANET FAYE (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:FAYE
Last Name:WASKO
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Gender:F
Credentials:NP
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Mailing Address - Street 1:50 DOUGLAS DRIVE SUITE 391
Mailing Address - Street 2:HEALTH SERVICES ADMINISTRATION
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4098
Mailing Address - Country:US
Mailing Address - Phone:925-957-5429
Mailing Address - Fax:925-957-5401
Practice Address - Street 1:2500 ALHAMBRA AVE
Practice Address - Street 2:CONTRA COSTA REGIONAL MEDICAL CENTER AND HEALTH CENTERS
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3156
Practice Address - Country:US
Practice Address - Phone:925-370-5110
Practice Address - Fax:925-370-5142
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN190754363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
R21900Medicare UPIN