Provider Demographics
NPI:1669164430
Name:HONG, JANE SUN (RN)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:SUN
Last Name:HONG
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 1:37988 DIVOT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-8092
Mailing Address - Country:US
Mailing Address - Phone:949-370-0963
Mailing Address - Fax:
Practice Address - Street 1:37988 DIVOT DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-8092
Practice Address - Country:US
Practice Address - Phone:949-370-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95241827163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse