Healthcare Provider Details

I. General information

NPI: 1124224241
Provider Name (Legal Business Name): JANENE ARTECHE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 FULLERTON AVE STE 140
CORONA CA
92881-3100
US

IV. Provider business mailing address

1511 PROSPECT AVE UNIT B
PLACENTIA CA
92870-3824
US

V. Phone/Fax

Practice location:
  • Phone: 951-549-0900
  • Fax: 951-278-8552
Mailing address:
  • Phone: 909-732-2475
  • Fax: 951-278-8552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1197018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: