Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 301103 18346 | CA |
NPI | 1053551853 |
---|---|
Provider Name | Janeen C Gaul |
First Address | Simi Valley, CA 93063-5722 |
Second Address | Los Angeles, CA 90095 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2009 |
Last Update Date | 06/03/2009 |