Provider Demographics
NPI:1518599711
Name:NDAME, JEAN-MARC JOJO (CRNA)
Entity Type:Individual
Prefix:
First Name:JEAN-MARC
Middle Name:JOJO
Last Name:NDAME
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 HANCOCK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-1561
Mailing Address - Country:US
Mailing Address - Phone:720-937-1705
Mailing Address - Fax:
Practice Address - Street 1:2473 HANCOCK DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-1561
Practice Address - Country:US
Practice Address - Phone:720-937-1705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001252367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered