Provider Demographics
NPI:1467792051
Name:WARREN, JANET ANNE (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANNE
Last Name:WARREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:CHAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19341 BEAR VALLEY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-5152
Mailing Address - Country:US
Mailing Address - Phone:760-241-6666
Mailing Address - Fax:609-475-6197
Practice Address - Street 1:19341 BEAR VALLEY RD STE 105
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-5152
Practice Address - Country:US
Practice Address - Phone:760-241-6666
Practice Address - Fax:609-475-6197
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22425OtherNP LICENSE