Provider Demographics
NPI:1184800716
Name:GOLETA, JONAE KAWEHELANI (RN, PHN)
Entity type:Individual
Prefix:
First Name:JONAE
Middle Name:KAWEHELANI
Last Name:GOLETA
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:JANAE
Other - Middle Name:KAWEHILANI
Other - Last Name:GOLETA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:690 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-7111
Mailing Address - Country:US
Mailing Address - Phone:619-409-3137
Mailing Address - Fax:619-409-3403
Practice Address - Street 1:690 OXFORD ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-7111
Practice Address - Country:US
Practice Address - Phone:619-409-3137
Practice Address - Fax:619-409-3403
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA643912163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse