Provider Demographics
NPI:1013368174
Name:WARD, JOHN PARKER (RN)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PARKER
Last Name:WARD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:355 TUOLUMNE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5700
Mailing Address - Country:US
Mailing Address - Phone:707-784-8987
Mailing Address - Fax:707-785-4014
Practice Address - Street 1:2101 COURAGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6717
Practice Address - Country:US
Practice Address - Phone:707-784-0802
Practice Address - Fax:707-425-4014
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA568293163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult