Provider Demographics
NPI:1578732731
Name:HANSEN, JANNA RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:RENEE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6657 FORGET ME NOT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-8313
Mailing Address - Country:US
Mailing Address - Phone:510-593-3355
Mailing Address - Fax:
Practice Address - Street 1:1444 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5319
Practice Address - Country:US
Practice Address - Phone:510-593-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor