Provider Demographics
NPI:1831656933
Name:CROFT, JOE FORREST (NP)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:FORREST
Last Name:CROFT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 JOHNSON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4154
Mailing Address - Country:US
Mailing Address - Phone:805-782-8844
Mailing Address - Fax:805-549-6985
Practice Address - Street 1:1941 JOHNSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4154
Practice Address - Country:US
Practice Address - Phone:805-782-8844
Practice Address - Fax:805-549-6985
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011128363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner