Provider Demographics
NPI:1659042521
Name:GAO, JOY (DNP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:GAO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 CENTER DR STE 603
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3063
Mailing Address - Country:US
Mailing Address - Phone:909-957-9323
Mailing Address - Fax:619-667-4550
Practice Address - Street 1:8851 CENTER DR STE 603
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3063
Practice Address - Country:US
Practice Address - Phone:619-667-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018214363LF0000X
CA96096242163WE0003X
390200000X
CA950182414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95018214OtherCA BRN FNP LICENSE
CA95018214OtherCA BRN FNP FURNISHING NUMBER