Provider Demographics
NPI:1497053649
Name:O'BRIEN, JANE PATRICIA (CRNA)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:PATRICIA
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:PATRICIA
Other - Last Name:O'BRIEN-KROENER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:310 SAGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6803
Mailing Address - Country:US
Mailing Address - Phone:714-595-6890
Mailing Address - Fax:
Practice Address - Street 1:310 SAGE ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-6803
Practice Address - Country:US
Practice Address - Phone:714-595-6890
Practice Address - Fax:805-439-3420
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2019-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4089367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered