MEDICARE: MR. JAY M JAVUREK NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	600165	CA

General Provider Information

NPI Number	:	1700534666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAY M JAVUREK NP

Provider Business Mailing Address
First Line	:	1990 EL MONTE DR
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-1820
Country	:	US
Telephone Number	:	805-907-6893
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 EL MONTE DR
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91362-1820
Country	:	US
Telephone Number	:	805-907-6893
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2022
Last Update Date	:	03/10/2022

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