Provider Demographics
NPI:1457429540
Name:PABON, JANEL (PA)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:PABON
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:3100 DOUGLAS BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3866
Practice Address - Country:US
Practice Address - Phone:916-774-8300
Practice Address - Fax:916-774-7145
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2015-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA14419363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PA144191Medicare PIN