Provider Demographics
NPI:1336409820
Name:MIZUNAKA, JOCELYN ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:ANN
Last Name:MIZUNAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:JOCELYN
Other - Middle Name:ANN
Other - Last Name:FONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3875 W BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-0795
Mailing Address - Country:US
Mailing Address - Phone:559-875-0557
Mailing Address - Fax:559-875-0575
Practice Address - Street 1:1570 7TH STREET
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:CA
Practice Address - Zip Code:93657
Practice Address - Country:US
Practice Address - Phone:559-875-0557
Practice Address - Fax:559-875-0575
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI18062207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine