Provider Demographics
NPI:1881721306
Name:JOHIRO, ANN KEIKO (MN, RN, FNP-BC, FNP-)
Entity type:Individual
Prefix:MISS
First Name:ANN
Middle Name:KEIKO
Last Name:JOHIRO
Suffix:
Gender:F
Credentials:MN, RN, FNP-BC, FNP-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3756 SANTA ROSALIA DR
Mailing Address - Street 2:SUITE 506
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3606
Mailing Address - Country:US
Mailing Address - Phone:323-617-5409
Mailing Address - Fax:323-544-6722
Practice Address - Street 1:3756 SANTA ROSALIA DR
Practice Address - Street 2:SUITE 506
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90008-3606
Practice Address - Country:US
Practice Address - Phone:323-617-5409
Practice Address - Fax:323-544-6722
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA4581363LF0000X, 363LP2300X
CA270013163W00000X
CA39468163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00NP45810Medicaid
CA00NP45810Medicaid
CAWNP4581AMedicare ID - Type UnspecifiedMEDICARE PPIN