Provider Demographics
NPI:1114555067
Name:PEREZ, JOANNA J (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:J
Last Name:PEREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2434 S CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-9039
Mailing Address - Country:US
Mailing Address - Phone:209-761-2058
Mailing Address - Fax:
Practice Address - Street 1:2434 S CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-9039
Practice Address - Country:US
Practice Address - Phone:209-761-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95075793163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse