Provider Demographics
NPI:1619106614
Name:SHAFFRON, JANET M (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:M
Last Name:SHAFFRON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15725 WHITTIER BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2350
Mailing Address - Country:US
Mailing Address - Phone:562-448-1350
Mailing Address - Fax:562-464-5122
Practice Address - Street 1:15725 WHITTIER BLVD STE 500
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2350
Practice Address - Country:US
Practice Address - Phone:562-448-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3700363L00000X
CA18255363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00869307OtherRAILROAD MEDICARE
AZ534762Medicaid
AZP00869307OtherRAILROAD MEDICARE