Provider Demographics
NPI:1215422340
Name:MAYER, JANICE E (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:E
Last Name:MAYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JANICE
Other - Middle Name:E
Other - Last Name:FLOCKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 1730
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-1058
Mailing Address - Country:US
Mailing Address - Phone:760-568-2684
Mailing Address - Fax:760-341-5832
Practice Address - Street 1:39000 BOB HOPE DRIVE
Practice Address - Street 2:HARRY & DIANE RINKER BUILDING
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-568-2684
Practice Address - Fax:760-837-2238
Is Sole Proprietor?:No
Enumeration Date:2018-07-01
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55603363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant