Provider Demographics
NPI:1235385378
Name:ERVIN-ASSIGAL, JANICE ELAINE (RN, CLNC)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:ELAINE
Last Name:ERVIN-ASSIGAL
Suffix:
Gender:F
Credentials:RN, CLNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3752
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92605-3752
Mailing Address - Country:US
Mailing Address - Phone:714-895-1985
Mailing Address - Fax:714-898-5269
Practice Address - Street 1:206 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3910
Practice Address - Country:US
Practice Address - Phone:714-895-1985
Practice Address - Fax:714-898-5269
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA369566163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator