Healthcare Provider Details

I. General information

NPI: 1992388540
Provider Name (Legal Business Name): JANET KWAN RN, PHN, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2021
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date: 06/20/2024
Reactivation Date: 08/14/2025

III. Provider practice location address

1320 MISSION RD
SOUTH SAN FRANCISCO CA
94080-1214
US

IV. Provider business mailing address

1320 MISSION RD
SOUTH SAN FRANCISCO CA
94080-1214
US

V. Phone/Fax

Practice location:
  • Phone: 650-877-8806
  • Fax:
Mailing address:
  • Phone: 650-877-8860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number22200827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: