Healthcare Provider Details

I. General information

NPI: 1215638499
Provider Name (Legal Business Name): JOVANA STOJANOVSKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 TROY PL
VISTA CA
92084-4831
US

IV. Provider business mailing address

2015 TROY PL
VISTA CA
92084-4831
US

V. Phone/Fax

Practice location:
  • Phone: 310-866-9934
  • Fax:
Mailing address:
  • Phone: 310-866-9934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number95087008
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number236332
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95022755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: