CRAIN, JANA MICHELLE (MD)

Provider Demographics

• NPI: 1376597716
• Name: CRAIN, JANA MICHELLE (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: JANA
• Middle Name: MICHELLE
• Last Name: CRAIN
• Gender: F
• Credentials: MD
• Other - Prefix: DR
• Other - First Name: JANA
• Other - Middle Name: MICHELLE
• Other - Last Name: ELLIOTT
• Other - Last Name Type: Other Name
• Other - Credentials: MD
• Mailing Address - Street 1: PO BOX 6102
• Mailing Address - City: NOVATO
• Mailing Address - State: CA
• Mailing Address - Zip Code: 94948-6102
• Mailing Address - Country: US
• Mailing Address - Phone: 415-884-3418
• Mailing Address - Fax: 415-883-8082
• Practice Address - Street 1: 3301 EL CAMINO REAL
• Practice Address - Street 2: SUITE 100
• Practice Address - City: ATHERTON
• Practice Address - State: CA
• Practice Address - Zip Code: 94027-3812
• Practice Address - Country: US
• Practice Address - Phone: 650-364-3080
• Is Sole Proprietor?: No
• Enumeration Date: 2006-05-20
• Last Update Date: 2010-12-21

Provider Licenses

State	License ID	Taxonomies
CA	A76445	2085R0202X
AK	5039	2085R0202X
AR	E-2321	2085R0202X
AZ	34768	2085R0202X
CO	41055	2085R0202X
NV	10330	2085R0202X
NY	227898-1	2085R0202X
OH	35086096	2085R0202X
OK	23139	2085R0202X
TX	L7345	2085R0202X
WA	MD00041779	2085R0202X
IL	036.115593	2085R0202X
MT	55	2085R0202X
NJ	25MA08140900	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CA	P00306111	Other	RAILROAD MEDICARE
AZ	111836	Medicaid
CO	38374366	Medicaid
CA	00A764450	Medicaid
OK	200097340A	Medicaid
CA	300134165	Other	RAILROAD MEDICARE
NV	1376597716	Medicaid
WA	8933498	Other	CVCP, L&I
WA	0167139	Other	L&I
WA	300136420	Other	RAILROAD MEDICARE
WA	8408726	Medicaid
CA	300134169	Other	RAILROAD MEDICARE
AR	P00335852	Other	RAILROAD MEDICARE
CA	P00306111	Other	RAILROAD MEDICARE
CA	00A764450	Medicaid
CA	BY129Q	Medicare PIN
NV	V105279	Medicare PIN
WA	AB35545	Medicare PIN
AR	5M722	Medicare PIN
CA	00A7644524	Medicare PIN
WA	8933498	Other	CVCP, L&I
CA	H59474	Medicare UPIN
CO	38374366	Medicaid
CA	BY129M	Medicare PIN
CA	BY129U	Medicare PIN
CA	BY129X	Medicare PIN
CA	BY129L	Medicare PIN
CA	00A7644511	Medicare PIN
AZ	111836	Medicaid
OK	200097340A	Medicaid
WA	8408726	Medicaid
CA	BY129T	Medicare PIN
CA	BY129V	Medicare PIN
CO	CO300371	Medicare PIN
CA	BY129W	Medicare PIN
CA	099984002	Medicare PIN
CA	00A764453	Medicare PIN
CA	00A7644519	Medicare PIN
CA	00A7644516	Medicare PIN
CA	00A764450	Medicare PIN
WA	300136420	Other	RAILROAD MEDICARE
CA	BY129O	Medicare PIN
CA	00A7644521	Medicare PIN
CA	00A7644517	Medicare PIN
CA	00A7644513	Medicare PIN