Healthcare Provider Details

I. General information

NPI: 1205264926
Provider Name (Legal Business Name): JANEL MOJICA FERNANDEZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANEL MOJICA TEAL

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 1ST ST STE A
SAN FRANCISCO CA
94105-2661
US

IV. Provider business mailing address

333 1ST ST STE A
SAN FRANCISCO CA
94105-2661
US

V. Phone/Fax

Practice location:
  • Phone: 415-840-0560
  • Fax: 415-779-8032
Mailing address:
  • Phone: 415-840-0560
  • Fax: 415-774-8032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number23219
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA08592
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: