Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 347984 | CA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | 347984 | CA |
NPI | 1043350085 |
---|---|
Provider Name | Gina Joanne Digiovanni |
First Address | Santa Monica, CA 90405-4619 |
Second Address | Pasadena, CA 91109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SS1964881 | (05) | CA |