Basic Information
Provider Information
NPI: 1275814428
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRANSON
FirstName: JANEL
MiddleName: ALISON
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9018 SKYLINE BLVD
Address2:  
City: OAKLAND
State: CA
PostalCode: 94611
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2410 CALIFORNIA ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941152681
CountryCode: US
TelephoneNumber: 4155294050
FaxNumber: 4152910489
Other Information
ProviderEnumerationDate: 09/01/2011
LastUpdateDate: 09/22/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X21125CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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