Provider Demographics
NPI:1093573560
Name:GATUS, JONIE ANNE
Entity Type:Individual
Prefix:
First Name:JONIE ANNE
Middle Name:
Last Name:GATUS
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 1:68640 SENORA RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CTY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-3810
Mailing Address - Country:US
Mailing Address - Phone:760-799-1464
Mailing Address - Fax:760-699-2454
Practice Address - Street 1:68640 SENORA RD
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CTY
Practice Address - State:CA
Practice Address - Zip Code:92234-3810
Practice Address - Country:US
Practice Address - Phone:760-799-1464
Practice Address - Fax:760-699-2454
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6003989740376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator