Provider Demographics
NPI:1053551853
Name:GAUL, JANEEN C (RN, NNP)
Entity type:Individual
Prefix:
First Name:JANEEN
Middle Name:C
Last Name:GAUL
Suffix:
Gender:F
Credentials:RN, NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 SITTING BULL PL
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-5722
Mailing Address - Country:US
Mailing Address - Phone:805-527-7737
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLAZA
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-267-7565
Practice Address - Fax:310-267-3599
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301103 18346363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care