MARK JASON JOEL SAN JOSE NPI 1043082233

NPI Information

NPI: 1043082233
Provider Name: MARK JASON JOEL SAN JOSE
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

Address:
15960 SERENADE LN
FONTANA, CA
ZIP 92336
Phone: (847) 222-3113
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Mark Jason Joel San Jose is an acute care nurse practitioner in Fontana, CA. Mark Jason Joel San Jose NPI is 1043082233. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15960 SERENADE LN
FONTANA, CA
ZIP 92336-076
Phone: (847) 222-3113

The enumeration date for this NPI number is 10/23/2023 and was last updated on 10/23/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	95027777	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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