Healthcare Provider Details

I. General information

NPI: 1164352290
Provider Name (Legal Business Name): JANICE ANN MCDOWELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANICE ANN LEE

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4058 WILLOWS RD
ALPINE CA
91901-1668
US

IV. Provider business mailing address

23425 TRAPPERS HOLLOW RD
ALPINE CA
91901-2507
US

V. Phone/Fax

Practice location:
  • Phone: 619-445-1188
  • Fax:
Mailing address:
  • Phone: 619-504-9924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number713206
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: