Provider Demographics
NPI:1922390384
Name:RATZLAFF, JANNA LYN (RN, NP, CNM)
Entity Type:Individual
Prefix:MRS
First Name:JANNA
Middle Name:LYN
Last Name:RATZLAFF
Suffix:
Gender:F
Credentials:RN, NP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-7153
Mailing Address - Country:US
Mailing Address - Phone:714-871-4415
Mailing Address - Fax:
Practice Address - Street 1:921 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-7153
Practice Address - Country:US
Practice Address - Phone:714-871-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19605363LW0102X
CA1877367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health