Provider Demographics
NPI:1831646744
Name:COHEN, JANA LIPSON (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:LIPSON
Last Name:COHEN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:MS
Other - First Name:JANA
Other - Middle Name:MICHELLE
Other - Last Name:LIPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 54679
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-9035
Practice Address - Country:US
Practice Address - Phone:310-423-5252
Practice Address - Fax:310-423-8441
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307999363LA2200X
CA95011715363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health