Healthcare Provider Details

I. General information

NPI: 1881540896
Provider Name (Legal Business Name): SHEVON RACHEL JANSEN APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 FLETCHER PKWY
EL CAJON CA
92020-2110
US

IV. Provider business mailing address

13634 CUNNING LN
LAKESIDE CA
92040-4406
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 561-455-6952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95350082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: