Provider Demographics
NPI:1720398332
Name:JOSHEAN NURSING CORPORATION
Entity Type:Organization
Organization Name:JOSHEAN NURSING CORPORATION
Other - Org Name:FALLBROOK HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:951-858-9221
Mailing Address - Street 1:34255 STARPOINT ST
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6517
Mailing Address - Country:US
Mailing Address - Phone:951-858-9221
Mailing Address - Fax:760-723-5906
Practice Address - Street 1:577 E ELDER ST STE E-2
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-723-5900
Practice Address - Fax:760-723-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF16355261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care