Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 95015620 | CA |
NPI | 1003403510 |
---|---|
Provider Name | Mrs. Joi Mei Soucy |
First Address | Palo Alto, CA 94305-2200 |
Second Address | Stanford, CA 94305-2295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2020 |
Last Update Date | 23/07/2021 |