Provider Demographics
NPI:1356985113
Name:COX, JANAE MICHELLE (NP)
Entity type:Individual
Prefix:
First Name:JANAE
Middle Name:MICHELLE
Last Name:COX
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4463 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-3327
Mailing Address - Country:US
Mailing Address - Phone:951-990-0409
Mailing Address - Fax:
Practice Address - Street 1:1902 ORANGE TREE LN STE 200
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-2800
Practice Address - Country:US
Practice Address - Phone:909-798-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013163363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95013163OtherNP LICENSE WITH THE BRN
2019038611OtherANCC NP CERTIFICATION #