Provider Demographics
NPI:1023589249
Name:CURREY, JANIE ISABELLE
Entity type:Individual
Prefix:MS
First Name:JANIE
Middle Name:ISABELLE
Last Name:CURREY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30183 COVE VIEW ST
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92587-7981
Mailing Address - Country:US
Mailing Address - Phone:909-576-0797
Mailing Address - Fax:
Practice Address - Street 1:30183 COVE VIEW ST
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-7981
Practice Address - Country:US
Practice Address - Phone:909-576-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX483302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization