Provider Demographics
NPI:1942372297
Name:GREENBERG, JANICE (RN,NP)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:RN,NP
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:H
Other - Last Name:TIPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,NP
Mailing Address - Street 1:1425 S MAIN ST
Mailing Address - Street 2:MOB2,3RD FL. SURGERY CLINIC
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5318
Mailing Address - Country:US
Mailing Address - Phone:925-295-5227
Mailing Address - Fax:925-295-4776
Practice Address - Street 1:1425 S MAIN ST
Practice Address - Street 2:MOB2,3RD FL. SURGERY CLINIC
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5318
Practice Address - Country:US
Practice Address - Phone:925-295-5227
Practice Address - Fax:925-295-4776
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP17852Medicare UPIN