Healthcare Provider Details

I. General information

NPI: 1336076835
Provider Name (Legal Business Name): JANE ANDERSON JACH MSN, RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 RIDGECREST DR
COLFAX CA
95713-9218
US

IV. Provider business mailing address

739 RIDGECREST DR
COLFAX CA
95713-9218
US

V. Phone/Fax

Practice location:
  • Phone: 510-478-5607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number779907
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: