Provider Demographics
NPI:1306078027
Name:CREADO, JANESSA JAMES (NP)
Entity type:Individual
Prefix:
First Name:JANESSA
Middle Name:JAMES
Last Name:CREADO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-862-3656
Mailing Address - Fax:562-862-2948
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:562-862-3656
Practice Address - Fax:562-862-2948
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily