Provider Demographics
NPI:1710353065
Name:JANI, ANASUYABEN DAHYALAL (NP)
Entity Type:Individual
Prefix:
First Name:ANASUYABEN
Middle Name:DAHYALAL
Last Name:JANI
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 1:18422 ARLINE AVE
Mailing Address - Street 2:APT#3
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5788
Mailing Address - Country:US
Mailing Address - Phone:562-809-1408
Mailing Address - Fax:
Practice Address - Street 1:18422 ARLINE AVE APT 3
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701
Practice Address - Country:US
Practice Address - Phone:337-400-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-20
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA793448390200000X
CA95003730363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program