Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 280382 | CA |
NPI | 1013918192 |
---|---|
Provider Name | Ms. Joan G Venturi |
First Address | Pleasanton, CA 94588-4501 |
Second Address | Pleasanton, CA 94588-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P19552 | (02) | CA |