Provider Demographics
NPI:1679457733
Name:LEMUS, JANEE MARIE
Entity type:Individual
Prefix:PROF
First Name:JANEE
Middle Name:MARIE
Last Name:LEMUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 GARY ST
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-4003
Mailing Address - Country:US
Mailing Address - Phone:408-415-7548
Mailing Address - Fax:
Practice Address - Street 1:9500 CLEVELAND AVE STE 180
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5905
Practice Address - Country:US
Practice Address - Phone:909-890-2054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI.E.H.PMedicaid