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NPI Code Detail

MEDICARE: LAURA ANN JANSSEN NP RN CNM

MEDICARE: LAURA ANN JANSSEN NP RN CNM
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
1163WW0101XAmbulatory Women's Health Care Registered Nurse433036CA
2363LW0102XWomen's Health Nurse Practitioner12926CA
3367A00000XAdvanced Practice Midwife758CA

General Provider Information

NPI Number : 1912019100
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN JANSSEN NP RN CNM
Provider Business Mailing Address
First Line : 3260 KERNER BLVD
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-4861
Country : US
Telephone Number : 415-499-4030
Fax Number : 415-499-5005
Provider Business Practice Location Address
First Line : 3260 KERNER BLVD
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-4861
Country : US
Telephone Number : 415-499-4030
Fax Number : 415-499-5005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/05/2009

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Directions to “ LAURA ANN JANSSEN NP RN CNM” Practice Location

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