MEDICARE: JOANN DUMAS FNP

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	163W00000X	Registered Nurse	NPF10862	CA

General Provider Information

NPI Number	:	1902987126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN DUMAS FNP

Provider Business Mailing Address
First Line	:	19850 LAKE CHABOT RD
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4002
Country	:	US
Telephone Number	:	510-582-8555
Fax Number	:	510-581-8686

Provider Business Practice Location Address
First Line	:	19850 LAKE CHABOT RD
Second Line	:
City	:	CASTRO VALLEY
State	:	CA
Zip	:	94546-4002
Country	:	US
Telephone Number	:	510-582-8555
Fax Number	:	510-581-8686

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/16/2007

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