Provider Demographics
NPI:1679874051
Name:MOROFSKI, JOHANNA (PA)
Entity Type:Individual
Prefix:MRS
First Name:JOHANNA
Middle Name:
Last Name:MOROFSKI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:MOROFSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:499 N EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1366
Mailing Address - Country:US
Mailing Address - Phone:760-436-6000
Mailing Address - Fax:
Practice Address - Street 1:1326 SEVEN OAKES RD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2306
Practice Address - Country:US
Practice Address - Phone:760-703-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-16
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19835363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical