Provider Demographics
NPI:1659563864
Name:PARTRIDGE, JOAN MARIE (RN, CNM, WHCNP)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:PARTRIDGE
Suffix:
Gender:F
Credentials:RN, CNM, WHCNP
Other - Prefix:MISS
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:D'AGOSTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1295 STILLWATER RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-5843
Mailing Address - Country:US
Mailing Address - Phone:951-735-7646
Mailing Address - Fax:
Practice Address - Street 1:10800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3043
Practice Address - Country:US
Practice Address - Phone:866-984-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-11
Last Update Date:2021-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1749367A00000X
CARN450366163WM0102X, 163WX0003X
CA17065363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
12283OtherCERTIFIED NURSE MIDWIFE
CA17065OtherNURSE PRACTITIONER
PAR1-0430-8146OtherWOMEN'S HEALTH CARE NP
PAR1-0430-8146OtherRNC IN INPATIENT OB
CA1749OtherNURSE MIDWIFE