Healthcare Provider Details

I. General information

NPI: 1194705632
Provider Name (Legal Business Name): JANET L. DEWEES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE
LA JOLLA CA
92037-1224
US

IV. Provider business mailing address

2372 BACK NINE ST
OCEANSIDE CA
92056-1701
US

V. Phone/Fax

Practice location:
  • Phone: 858-552-9177
  • Fax:
Mailing address:
  • Phone: 910-382-6924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN31416
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95000151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: