Judy Lane, N.P., R.N.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

501901 Issued in CA

Practice address

25 Mitchell Blvd
Suite 8
San Rafael, CA 94903-2007

Phone

(415) 472-2343

Fax

(415) 472-7636

NPI assigned

May 23, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Preventive Medical Center of Marin Inc

  • Primary Care Clinic/Center
  • San Rafael, CA
  • NPI 1912067828
  Medicare reassignment NPD
• Rasnow Integrative Wellness Inc

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1801438015
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043420896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MARIN VALLEY DR",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496806",
            "telephone_number": "415-883-3955",
            "fax_number": "415-472-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD",
            "address_2": "SUITE 8",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032007",
            "telephone_number": "415-472-2343",
            "fax_number": "415-472-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JUDY",
        "name_prefix": "Ms.",
        "credential": "N.P., R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "501901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph James Lamson, PH.D.
• Erinn Burke Lance, NP CNM RN
• Sally Landis, RDA
• Dena Marie Landrum, M.F.T.
• Paul Raymond Landrum, PH.D. M.F.T.
• Lawrence M Lanes, MD
• Jeanni Clancey Lang
• Amy Lanoue
• Rita L Lanphier, D.D.S.
• Gabriela Liliana Lara

• Adult Health Nurse Practitioner in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.