Provider Demographics
NPI:1023391216
Name:VAVAO, JOLI (NP)
Entity Type:Individual
Prefix:MRS
First Name:JOLI
Middle Name:
Last Name:VAVAO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR.
Mailing Address - Street 2:ROOM R 281
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5327
Mailing Address - Country:US
Mailing Address - Phone:650-723-5575
Mailing Address - Fax:650-724-9232
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:ROOM R 281
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-5575
Practice Address - Fax:650-724-9232
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549882363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care