Provider Demographics
NPI:1104414291
Name:KNESEK, JANET MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:KNESEK
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:JANET
Other - Middle Name:M
Other - Last Name:KNESEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11130 JORDAN RIVER CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2945
Mailing Address - Country:US
Mailing Address - Phone:916-622-2830
Mailing Address - Fax:
Practice Address - Street 1:3301 ZINFANDEL DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-6385
Practice Address - Country:US
Practice Address - Phone:916-852-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA622725163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse