Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A10416 | CA |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34006832B | OH |
N | 207Q00000X | Family Doctor | 10416 | CA |
N | 207Q00000X | Family Doctor | 20A10416 | CA |
NPI | 1427016005 |
---|---|
Provider Name | Mrs. Janet Marie Burns |
First Address | Vallejo, CA 94591-7765 |
Second Address | Walnut Creek, CA 94596-5219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 22/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000246244 | ANTHEM BCBS (01) | |
2342218 | (05) | OH |
G79416 | (02) |