Provider Demographics
NPI:1548313331
Name:PRUDHOMME, JANICE CECILE (DO)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:CECILE
Last Name:PRUDHOMME
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:26 ARLMONT DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:94707-1004
Mailing Address - Country:US
Mailing Address - Phone:510-559-8076
Mailing Address - Fax:510-559-8076
Practice Address - Street 1:3100 TELEGRAPH AVE
Practice Address - Street 2:SUITE #4100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3210
Practice Address - Country:US
Practice Address - Phone:510-869-8920
Practice Address - Fax:510-869-6903
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20 A61462083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine