Healthcare Provider Details

I. General information

NPI: 1659342525
Provider Name (Legal Business Name): JANICE C. STINSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ASHBY AVE
BERKELEY CA
94705-2067
US

IV. Provider business mailing address

9 DRESDEN BAY
ALAMEDA CA
94502-6536
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-1572
  • Fax: 510-548-2160
Mailing address:
  • Phone: 510-769-8961
  • Fax: 510-864-8920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number422985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: