Provider Demographics
NPI:1003992942
Name:EASTWOOD, JO-ANN ORSILLO (PHD, RN,CCNS,CCRN)
Entity Type:Individual
Prefix:MS
First Name:JO-ANN
Middle Name:ORSILLO
Last Name:EASTWOOD
Suffix:
Gender:F
Credentials:PHD, RN,CCNS,CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 FAYMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4212
Mailing Address - Country:US
Mailing Address - Phone:310-206-3443
Mailing Address - Fax:310-794-7482
Practice Address - Street 1:4-940 UCLA SCHOOL OF NURSING FACTOR
Practice Address - Street 2:700 TIVERTON BLVD.BOX 956918
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-6918
Practice Address - Country:US
Practice Address - Phone:310-206-3443
Practice Address - Fax:310-794-7482
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232442163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine