Provider Demographics
NPI:1295073948
Name:MCGIRT, JANESSA M
Entity type:Individual
Prefix:
First Name:JANESSA
Middle Name:M
Last Name:MCGIRT
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 1:1069 BROADWAY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:CA
Mailing Address - Zip Code:93955-4995
Mailing Address - Country:US
Mailing Address - Phone:831-393-1500
Mailing Address - Fax:
Practice Address - Street 1:1069 BROADWAY AVE STE 201
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955-4995
Practice Address - Country:US
Practice Address - Phone:831-393-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program