Healthcare Provider Details

I. General information

NPI: 1477625549
Provider Name (Legal Business Name): NANCY JANE BEJUNE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7621 CANOGA AVE
CANOGA PARK CA
91304-4912
US

IV. Provider business mailing address

17341 LEMAC ST
NORTHRIDGE CA
91325-4519
US

V. Phone/Fax

Practice location:
  • Phone: 818-598-6900
  • Fax: 818-598-6971
Mailing address:
  • Phone: 818-996-4409
  • Fax: 818-598-6971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number190003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: