Provider Demographics
NPI:1215657887
Name:SAETURN, JANELLE
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:SAETURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2486 MIA WAY
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-6761
Mailing Address - Country:US
Mailing Address - Phone:510-381-2997
Mailing Address - Fax:
Practice Address - Street 1:2486 MIA WAY
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-6761
Practice Address - Country:US
Practice Address - Phone:510-381-2997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD1648704343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)