Broussard, Janessa Marie

Broussard, Janessa Marie is an individual health care provider with primary practice located at 470 Castro St , San Francisco CA 94114-2482. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Broussard, Janessa Marie can be contacted via phone (415) 581-1600.

Contact Information

Primary practice address
470 Castro St San Francisco CA 94114-2482
Phone: (415) 581-1600
Fax: (415) 581-1610
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 95007103 California

Profile Details

NPI number 1285159871
LBN Legal business name Broussard, Janessa Marie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2017
Last updated Dec 13th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285159871 NPPES
California Other 95007103 NP LICENSE

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