NPI Code Detail JSON Logo

1124683008 NPI number — JOANNA KRISTINE AFFOLTER

NPI Number: 1124683008
Health Care Provider/Practitioner: JOANNA KRISTINE AFFOLTER

Information about “1124683008” NPI (JOANNA KRISTINE AFFOLTER) exists in 1124683008 in HTML format HTML  |  1124683008 in plain Text format TXT  |  1124683008 in PDF (Portable Document Format) PDF  |  1124683008 in an XML format XML  formats.

NPI Number : 1124683008 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124683008",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "AFFOLTER",
    "FirstName": "JOANNA",
    "MiddleName": "KRISTINE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "CLEMENS",
    "OtherFirstName": "JOANNA",
    "OtherMiddleName": "KRISTINE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "24240 AWAHANEE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SONORA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95370-8333",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "209-694-6004",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1904 RICHLAND AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CERES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95307-4562",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "209-300-8800",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/06/2019",
    "LastUpdateDate": "05/06/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "163WP0808X",
        "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
        "LicenseNumber": "95053961",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.