Provider Demographics
NPI:1790965812
Name:GRIJALVA, JOANNA (CNA)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:
Last Name:GRIJALVA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23131 PENNSGROVE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7025
Mailing Address - Country:US
Mailing Address - Phone:281-784-1924
Mailing Address - Fax:
Practice Address - Street 1:23131 PENNSGROVE RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7025
Practice Address - Country:US
Practice Address - Phone:281-784-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11818423374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide