MEDICARE: JOANN THORSHEIM N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP1114	CA

General Provider Information

NPI Number	:	1427087618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN THORSHEIM N.P.

Provider Business Mailing Address
First Line	:	68860 PEREZ RD STE J
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7248
Country	:	US
Telephone Number	:	760-328-4499
Fax Number	:	760-328-1050

Provider Business Practice Location Address
First Line	:	68860 PEREZ RD STE J
Second Line	:
City	:	CATHEDRAL CITY
State	:	CA
Zip	:	92234-7248
Country	:	US
Telephone Number	:	760-328-4499
Fax Number	:	760-328-1050

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	07/08/2007

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