Roberts, Joanna Lyn

Roberts, Joanna Lyn is an individual health care provider with primary practice located at 411 Grand Ave , Oakland CA 94610-5022. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Roberts, Joanna Lyn can be contacted via phone (510) 844-4097.

Contact Information

Primary practice address
411 Grand Ave Oakland CA 94610-5022
Phone: (510) 844-4097
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 52879 California

Profile Details

NPI number 1164559506
LBN Legal business name Roberts, Joanna Lyn
Credentials PA, PTA
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2007
Last updated Apr 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164559506 NPPES
Arizona MEDICAID 904080

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