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JOANNA KRISTINE AFFOLTER

Psychiatric/Mental Health >> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1124683008

Individual Registrant:
 JOANNA KRISTINE AFFOLTER 
Gender: F
Sole Proprietor

Location and contact information for practice:
1904 RICHLAND AVE  CERES, CA 95307-4562 US
Tel: 209-300-8800  Fax: --

Contact information for business:
24240 AWAHANEE RD  SONORA, CA 95370-8333 US
Tel: 209-694-6004  Fax: --

Registration Information:
NPI: 1124683008
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163WP0808XNursing Service Providers
Registered Nurse
Psychiatric/Mental Health
CA95053961

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
REGISTERED NURSE95053961CA01




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