Provider Demographics
NPI:1992388540
Name:KWAN, JANET (RN, PHN, CDCES)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:KWAN
Suffix:
Gender:F
Credentials:RN, PHN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1214
Mailing Address - Country:US
Mailing Address - Phone:650-877-8860
Mailing Address - Fax:
Practice Address - Street 1:1320 MISSION RD
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-1214
Practice Address - Country:US
Practice Address - Phone:650-877-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2025-08-18
Deactivation Date:2024-06-20
Deactivation Code:
Reactivation Date:2025-08-14
Provider Licenses
StateLicense IDTaxonomies
CA22200827163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00000Medicaid