Provider Demographics
NPI:1043574080
Name:STROHL, JONATHAN CARNEY (PMHNP)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:CARNEY
Last Name:STROHL
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3835 N FREEWAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1954
Mailing Address - Country:US
Mailing Address - Phone:916-576-7900
Mailing Address - Fax:916-285-0338
Practice Address - Street 1:201 N CIVIC DR STE 183
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3864
Practice Address - Country:US
Practice Address - Phone:925-299-9033
Practice Address - Fax:925-299-9030
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23463363LP0808X
CA658002390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program