Provider Demographics
NPI:1528125945
Name:MERTENS, JANE (MD)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:MERTENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 9TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2717
Mailing Address - Country:US
Mailing Address - Phone:858-793-8336
Mailing Address - Fax:858-551-8288
Practice Address - Street 1:240 9TH ST
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2717
Practice Address - Country:US
Practice Address - Phone:858-793-8336
Practice Address - Fax:858-551-8288
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA427372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry