Healthcare Provider Details

I. General information

NPI: 1841247137
Provider Name (Legal Business Name): JOAN MARIE PRESSIMONE PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOAN MARIE KENNEDY

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 W LAS POSITAS BLVD
PLEASANTON CA
94588
US

IV. Provider business mailing address

PO BOX 4155
SAN DIMAS CA
91773-8155
US

V. Phone/Fax

Practice location:
  • Phone: 925-416-6585
  • Fax: 626-623-1227
Mailing address:
  • Phone: 626-447-0296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number008359
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA54423
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: