Healthcare Provider Details

I. General information

NPI: 1598044943
Provider Name (Legal Business Name): JOYCE ANNETTE MOSS RN,BSN,MN,CWS, CWCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2011
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

541 ALBORAN SEA CIR
SACRAMENTO CA
95834-7543
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-5109
  • Fax:
Mailing address:
  • Phone: 916-514-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number435359
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: