Provider Demographics
NPI:1134357973
Name:ACOBA, JANINE KLAIR TARCULAS (RN, CNS, ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JANINE KLAIR
Middle Name:TARCULAS
Last Name:ACOBA
Suffix:
Gender:F
Credentials:RN, CNS, ACNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:22003 S VERMONT AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2123
Mailing Address - Country:US
Mailing Address - Phone:951-543-6148
Mailing Address - Fax:
Practice Address - Street 1:22003 S VERMONT AVE APT 30
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2123
Practice Address - Country:US
Practice Address - Phone:951-543-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA651778163W00000X
CA21173363LA2100X
CA3650364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist