Healthcare Provider Details

I. General information

NPI: 1922184886
Provider Name (Legal Business Name): JEANETTE TOTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANETTE TOTH FNP

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CHURCH STREET
MURPHYS CA
95247
US

IV. Provider business mailing address

PO BOX 987
MURPHYS CA
95247-0987
US

V. Phone/Fax

Practice location:
  • Phone: 209-728-2021
  • Fax: 209-728-8752
Mailing address:
  • Phone: 209-728-8048
  • Fax: 209-533-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN280998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: