Provider Demographics
NPI:1639466832
Name:MAS, JAYNE ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:JAYNE
Middle Name:ANN
Last Name:MAS
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:1 LMU DRIVE MS 8455
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2659
Mailing Address - Country:US
Mailing Address - Phone:310-338-2881
Mailing Address - Fax:310-338-4417
Practice Address - Street 1:1 LMU DRIVE MS 8455
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-2659
Practice Address - Country:US
Practice Address - Phone:310-338-2881
Practice Address - Fax:310-338-4417
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA436599363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool