Provider Demographics
NPI:1790499846
Name:MCCARTHY, JANA (LVN)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24896 JERONIMO LN
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-4020
Mailing Address - Country:US
Mailing Address - Phone:949-400-7254
Mailing Address - Fax:
Practice Address - Street 1:24896 JERONIMO LN
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4020
Practice Address - Country:US
Practice Address - Phone:949-400-7254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN55393164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse