Provider Demographics
NPI:1376965111
Name:HERSHENHOUSE, JAN ELLEN (DVM)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:ELLEN
Last Name:HERSHENHOUSE
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7351 RANCHO VERDE LN
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-8524
Mailing Address - Country:US
Mailing Address - Phone:916-652-5519
Mailing Address - Fax:916-652-5519
Practice Address - Street 1:7351 RANCHO VERDE LN
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-8524
Practice Address - Country:US
Practice Address - Phone:916-652-5519
Practice Address - Fax:916-652-5519
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5828174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAH1879456OtherDRUG ENFORCEMENT ADMINISTRATION