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General NPI Number Information
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NPI Number | 1225376197
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Entity Type | Individual
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Provider Name | JALYNNE NONE SOUSA NP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2013
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Last Update Date | 01/28/2013
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Provider Practice Location Address
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Address Line | 3431 BROADWAY
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City | VALLEJO
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State | CA
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Zip | 94592-1189
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Country | US
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Telephone | 707-683-5220
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Fax |
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Provider Business Mailing Address
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Address Line | 2562 MARSHFIELD ROAD
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City | VALLEJO
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State | CA
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Zip | 94592-1189
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Country | US
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Telephone | 707-683-5220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12673
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License Number State | CA
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