Healthcare Provider Details

I. General information

NPI: 1942372297
Provider Name (Legal Business Name): JANICE GREENBERG R.N.,N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANICE H TIPPER R.N.,N.P.

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 02/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S MAIN ST MOB2,3RD FL. SURGERY CLINIC
WALNUT CREEK CA
94596-5318
US

IV. Provider business mailing address

1425 S MAIN ST MOB2,3RD FL. SURGERY CLINIC
WALNUT CREEK CA
94596-5318
US

V. Phone/Fax

Practice location:
  • Phone: 925-295-5227
  • Fax: 925-295-4776
Mailing address:
  • Phone: 925-295-5227
  • Fax: 925-295-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number291722
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: