Healthcare Provider Details

I. General information

NPI: 1912466673
Provider Name (Legal Business Name): PRISCILLA MILTON-JANKANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 PASSONS BLVD UNIT 1248
PICO RIVERA CA
90660-7161
US

IV. Provider business mailing address

9490 DAHLIA WAY
PICO RIVERA CA
90660-4243
US

V. Phone/Fax

Practice location:
  • Phone: 424-274-2082
  • Fax:
Mailing address:
  • Phone: 323-516-4907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95010383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: