Individual provider Active NPI

Laura Ann Janssen, NP RN CNM

  • Advanced Practice Midwife
  • San Rafael, CA
National Provider Identifier
1912019100
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
758 Issued in CA
Practice address
3260 Kerner Blvd
San Rafael, CA 94901-4861
Phone
(415) 499-4030
Fax
(415) 499-5005
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X 433036 CA
Women's Health Nurse Practitioner 363LW0102X 12926 CA
Advanced Practice Midwife 367A00000X 758 CA Primary

Addresses

Primary practice location

3260 Kerner Blvd
San Rafael, CA 94901-4861

Mailing address

3260 Kerner Blvd
San Rafael, CA 94901-4861
Phone (415) 499-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
433036CAMDAmbulatory Women's Health Care Registered Nurse
12926CAMDSpeech-Language Pathologist
758CAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1912019100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014861",
            "telephone_number": "415-499-4030",
            "fax_number": "415-499-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 KERNER BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949014861",
            "telephone_number": "415-499-4030",
            "fax_number": "415-499-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "NP RN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "433036",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "12926",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.