Provider Demographics
NPI:1821133281
Name:JONES, JANET BERNADETTE (RN,PHN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:BERNADETTE
Last Name:JONES
Suffix:
Gender:F
Credentials:RN,PHN, FNP
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:BERNADETTE
Other - Last Name:TRUJILLOJONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP
Mailing Address - Street 1:5543 RALSTON WAY
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-8611
Mailing Address - Country:US
Mailing Address - Phone:209-946-2316
Mailing Address - Fax:209-946-3001
Practice Address - Street 1:3601 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95211-0110
Practice Address - Country:US
Practice Address - Phone:209-946-2316
Practice Address - Fax:209-946-3001
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN660706364SC1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19328OtherCALIFORNIA NURSE PRACTITIONER