MEDICARE: MS. JANE M. PERLAS FNP-C

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	363LF0000X	Family Nurse Practitioner	398401	CA

General Provider Information

NPI Number	:	1750370904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANE M. PERLAS FNP-C

Provider Business Mailing Address
First Line	:	87 SEAGULL DR
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94804-7408
Country	:	US
Telephone Number	:	510-235-9432
Fax Number	:	510-235-9432

Provider Business Practice Location Address
First Line	:	1001 POTRERO AVE
Second Line	:	5H6
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-3518
Country	:	US
Telephone Number	:	415-206-6876
Fax Number	:	415-206-3053

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	07/08/2007

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