Provider Demographics
NPI:1508093220
Name:PARDY, JANE DI ANGELO
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:DI ANGELO
Last Name:PARDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CHELSEA CIR
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-4688
Mailing Address - Country:US
Mailing Address - Phone:760-485-0076
Mailing Address - Fax:760-674-2187
Practice Address - Street 1:515 N PALM CANYON DR
Practice Address - Street 2:SUITE 514, # 1
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5543
Practice Address - Country:US
Practice Address - Phone:760-485-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-20
Last Update Date:2009-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR2174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist