Provider Demographics
NPI:1750370904
Name:PERLAS, JANE M (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:M
Last Name:PERLAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 SEAGULL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804-7408
Mailing Address - Country:US
Mailing Address - Phone:510-235-9432
Mailing Address - Fax:510-235-9432
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:5H6
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-6876
Practice Address - Fax:415-206-3053
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398401363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS69664Medicare UPIN