Basic Information
| Provider Information | |||||||||
| NPI: | 1790432185 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOANIS | ||||||||
| FirstName: | DOROTHY | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 38121 25TH ST E APT P101 | ||||||||
| Address2: | |||||||||
| City: | PALMDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 935501302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187993637 | ||||||||
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| Practice Location | |||||||||
| Address1: | 14850 ROSCOE BLVD | ||||||||
| Address2: | |||||||||
| City: | PANORAMA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914024618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187872222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/04/2022 | ||||||||
| LastUpdateDate: | 03/04/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 95020117 | CA | Y | Hospital Units | Psychiatric Unit |
No ID Information.