Basic Information
Provider Information
NPI: 1154537256
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMOND
FirstName: JANICE
MiddleName: KIRSTINE
NamePrefix: MS.
NameSuffix:  
Credential: C.N.M.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 W COOLIDGE AVE
Address2:  
City: MODESTO
State: CA
PostalCode: 953504447
CountryCode: US
TelephoneNumber: 2095775005
FaxNumber: 2095211533
Practice Location
Address1: 200 W COOLIDGE AVE
Address2:  
City: MODESTO
State: CA
PostalCode: 953504447
CountryCode: US
TelephoneNumber: 2095775005
FaxNumber: 2095211533
Other Information
ProviderEnumerationDate: 05/15/2007
LastUpdateDate: 02/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XCNMW-178CAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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