Provider Demographics
NPI:1891221263
Name:JANUS, OLIVIA IRENE (PA)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:IRENE
Last Name:JANUS
Suffix:
Gender:F
Credentials:PA
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Other - Last Name:
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Mailing Address - Street 1:800 PEACHTREE ST NE
Mailing Address - Street 2:UNIT 8515
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2019-12-03
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant