Provider Demographics
NPI:1386357085
Name:MISLANG, JAYNE
Entity type:Individual
Prefix:MISS
First Name:JAYNE
Middle Name:
Last Name:MISLANG
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 1:2500 S C ST STE D
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4574
Mailing Address - Country:US
Mailing Address - Phone:805-859-4603
Mailing Address - Fax:805-385-9407
Practice Address - Street 1:2500 S C ST STE D
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-4574
Practice Address - Country:US
Practice Address - Phone:805-385-9460
Practice Address - Fax:805-385-9407
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA349320163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA349320OtherBRN