Provider Demographics
NPI:1780117093
Name:FARRELL, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 LAUREL CANYON BLVD
Mailing Address - Street 2:APT 27
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2178
Mailing Address - Country:US
Mailing Address - Phone:646-533-5986
Mailing Address - Fax:
Practice Address - Street 1:5519 LAUREL CANYON BLVD
Practice Address - Street 2:APT 27
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-2178
Practice Address - Country:US
Practice Address - Phone:646-533-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula