Healthcare Provider Details

I. General information

NPI: 1093908766
Provider Name (Legal Business Name): JANIE ANN SALAZAR APRN, FNP, MSN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANE ANN OLSEN RN, BSN

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL MOB-CHILD ADVOCACY CLINIC SUITE 105
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6022
  • Fax: 559-353-7176
Mailing address:
  • Phone: 559-353-6022
  • Fax: 559-353-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1102X
TaxonomyMilitary Outpatient Operational (Transportable) Component Clinic/Center
License NumberAPRN-967
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number376865
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-967
License Number StateHI
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: