Provider Demographics
NPI:1639416373
Name:COOK, JANE FRANCE (RN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:FRANCE
Last Name:COOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816614 AVENIDA CELAYA
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-4107
Mailing Address - Country:US
Mailing Address - Phone:760-698-9402
Mailing Address - Fax:
Practice Address - Street 1:81614 AVENIDA CELAYA
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-4107
Practice Address - Country:US
Practice Address - Phone:760-698-9402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA221415163W00000X
CA97000163WC0400X
CA475999163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA221514OtherREGISTERED NURSE
CA47599OtherPUBLIC HEALTH (PHN)
CA97000OtherCCM (CERTIFIED CASE MANAGER )