Provider Demographics
NPI:1437277159
Name:HANSEN, JEANNE ELAINE (PHN)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:ELAINE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 SANTA HELENA
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1641
Mailing Address - Country:US
Mailing Address - Phone:858-259-5464
Mailing Address - Fax:
Practice Address - Street 1:5202 UNIVERSITY AVE.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-701-5750
Practice Address - Fax:619-285-5584
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA164477163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health