Basic Information
| Provider Information | |||||||||
| NPI: | 1174580575 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELA CRUZ | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | DE GUZMAN | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2355 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003104872 | ||||||||
| FaxNumber: | 8773284823 | ||||||||
| Practice Location | |||||||||
| Address1: | 15141 E WHITTLER BLVD | ||||||||
| Address2: | STE 225 | ||||||||
| City: | WHITTLER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626983536 | ||||||||
| FaxNumber: | 5623983945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 481470 | CA | X | Nursing Service Providers | Registered Nurse | 363L00000X | 15586 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 15586 | CA | X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.