MEDICARE: MS. JAYNE ANN MAS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LS0200X	School Nurse Practitioner	436599	CA

General Provider Information

NPI Number	:	1639466832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAYNE ANN MAS NP

Provider Business Mailing Address
First Line	:	1 LMU DRIVE MS 8455
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-2659
Country	:	US
Telephone Number	:	310-338-2881
Fax Number	:	310-338-4417

Provider Business Practice Location Address
First Line	:	1 LMU DRIVE MS 8455
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-2659
Country	:	US
Telephone Number	:	310-338-2881
Fax Number	:	310-338-4417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	07/08/2011

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