Provider Demographics
NPI:1437291424
Name:GARNER, JANE LOUISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:LOUISE
Last Name:GARNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-2119
Mailing Address - Country:US
Mailing Address - Phone:510-849-9464
Mailing Address - Fax:510-849-9469
Practice Address - Street 1:192 BEACON ST
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-6913
Practice Address - Country:US
Practice Address - Phone:650-589-6500
Practice Address - Fax:650-589-7256
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA10299363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical