Healthcare Provider Details

I. General information

NPI: 1194817353
Provider Name (Legal Business Name): JANET VAN EPPS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 STUDENT HEALTH UCI
IRVINE CA
92697-5200
US

IV. Provider business mailing address

33801 BLESSINGTON LN
SAN JUAN CAPISTRANO CA
92675-4958
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-7658
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number539492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: