Individual
JANEIKO CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 RUSTIN AVE STE 5, RIVERSIDE, CA 92507-2498
(951) 509-2400
(951) 509-2405
Mailing address
2085 RUSTIN AVE STE 5, RIVERSIDE, CA 92507-2498
(951) 509-2400
(951) 509-2405
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
581070
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
581070
RN LICENSE
CA
Enumeration date
07/02/2018
Last updated
07/02/2018
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