Provider Demographics
NPI:1861676462
Name:BEER, JEANETTE LOUISE (RN, PHN)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:LOUISE
Last Name:BEER
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-795-3619
Mailing Address - Fax:
Practice Address - Street 1:4555 PRECISSI LN
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6239
Practice Address - Country:US
Practice Address - Phone:209-477-4103
Practice Address - Fax:209-477-1065
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA638882163W00000X
CA95003705363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse