Provider Demographics
NPI:1154537256
Name:HAMMOND, JANICE KIRSTINE (CNM)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:KIRSTINE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4447
Mailing Address - Country:US
Mailing Address - Phone:209-577-5005
Mailing Address - Fax:209-521-1533
Practice Address - Street 1:200 W COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4447
Practice Address - Country:US
Practice Address - Phone:209-577-5005
Practice Address - Fax:209-521-1533
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNMW-178367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP10835Medicare UPIN