Individual
JAN SHODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
1725 W 17TH ST, SANTA ANA, CA 92706-2316
(714) 834-8485
Mailing address
1725 W 17TH ST, SANTA ANA, CA 92706-2316
(714) 834-8485
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
301667
CA
Other
Enumeration date
10/25/2006
Last updated
07/11/2007
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