Provider Demographics
NPI:1689621005
Name:JONES, JOANNE (FNP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23456 MADERO
Mailing Address - Street 2:STE. 185
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2701
Mailing Address - Country:US
Mailing Address - Phone:949-716-9464
Mailing Address - Fax:
Practice Address - Street 1:23456 MADERO
Practice Address - Street 2:STE. 185
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2701
Practice Address - Country:US
Practice Address - Phone:949-716-9464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN915067600Medicaid
MN500003416Medicare Oscar/Certification
MNS90011Medicare UPIN