MEDICARE: JOANNA JANE PLUMETTAZ PA

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	363AM0700X	Medical Physician Assistant	PA09577	TX
2	363A00000X	Physician Assistant	PA62986	CA
3	363A00000X	Physician Assistant	PA09577	TX

General Provider Information

NPI Number	:	1588062145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA JANE PLUMETTAZ PA

Provider Business Mailing Address
First Line	:	1100 TRANCAS ST STE 256
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94558-2921
Country	:	US
Telephone Number	:	707-251-3604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 TRANCAS ST STE 256
Second Line	:
City	:	NAPA
State	:	CA
Zip	:	94558-2921
Country	:	US
Telephone Number	:	707-251-3604
Fax Number	:

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

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	12/29/2025

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Directions to “ JOANNA JANE PLUMETTAZ PA” Practice Location

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