Provider Demographics
NPI:1457603987
Name:HANSEN, JANICE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:MARIE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36766 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8622
Mailing Address - Country:US
Mailing Address - Phone:213-339-7864
Mailing Address - Fax:
Practice Address - Street 1:36766 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8622
Practice Address - Country:US
Practice Address - Phone:213-339-7864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2012-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA723657163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics