Provider Demographics
NPI:1356332951
Name:OPPENHEIM, JOANNA (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:OPPENHEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2292
Mailing Address - Country:US
Mailing Address - Phone:831-208-6226
Mailing Address - Fax:831-208-6225
Practice Address - Street 1:1260 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2292
Practice Address - Country:US
Practice Address - Phone:831-208-6226
Practice Address - Fax:831-208-6225
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H33978Medicare UPIN