Provider Demographics
NPI:1407235708
Name:KLEIN, JOANNA ROSE (NP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:ROSE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:ROSE
Other - Last Name:AMBROSY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:2100 WEBSTER ST STE 516
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2381
Mailing Address - Country:US
Mailing Address - Phone:415-537-8600
Mailing Address - Fax:415-369-1371
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-537-8600
Practice Address - Fax:415-369-1371
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001552363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95001552OtherSTATE MEDICAL LICENSE
CANPF95001552OtherSTATE MEDICAL LICENSE