Provider Demographics
NPI:1508952730
Name:ATIENZA, JANET R (NP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:R
Last Name:ATIENZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W 3RD ST
Mailing Address - Street 2:STE 500
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1938
Mailing Address - Country:US
Mailing Address - Phone:818-907-0892
Mailing Address - Fax:
Practice Address - Street 1:2200 W 3RD ST
Practice Address - Street 2:STE 500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-1938
Practice Address - Country:US
Practice Address - Phone:818-907-0892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498125363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner