Healthcare Provider Details

I. General information

NPI: 1346396918
Provider Name (Legal Business Name): JO-ANN HARTONG R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 LOVERIDGE RD
PITTSBURG CA
94565-5117
US

IV. Provider business mailing address

3483 HAMLIN RD
LAFAYETTE CA
94549-5020
US

V. Phone/Fax

Practice location:
  • Phone: 925-431-2641
  • Fax: 925-431-2665
Mailing address:
  • Phone: 925-431-2641
  • Fax: 925-431-2665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number388402
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: