Provider Demographics
NPI:1780201087
Name:NORIEGA, JOVANNA A
Entity Type:Individual
Prefix:
First Name:JOVANNA
Middle Name:A
Last Name:NORIEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4533 E ROLLING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-9576
Mailing Address - Country:US
Mailing Address - Phone:480-584-6467
Mailing Address - Fax:
Practice Address - Street 1:4533 E ROLLING RIDGE RD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-9576
Practice Address - Country:US
Practice Address - Phone:480-584-6467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider