Basic Information
| Provider Information | |||||||||
| NPI: | 1740476118 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAY | ||||||||
| FirstName: | JOHANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 CREEKSIDE DR | ||||||||
| Address2: | SUITE 2100 | ||||||||
| City: | FOLSOM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956303444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169832663 | ||||||||
| FaxNumber: | 9169830602 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 CREEKSIDE DR | ||||||||
| Address2: | SUITE 2100 | ||||||||
| City: | FOLSOM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956303444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169832663 | ||||||||
| FaxNumber: | 9169830602 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2007 | ||||||||
| LastUpdateDate: | 09/19/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SF0001X | RN417727 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Family Health |
No ID Information.