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General NPI Number Information
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NPI Number | 1396551537
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Entity Type | Individual
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Provider Name | JOI KOOGLER
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 811 GRAND AVE
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City | SACRAMENTO
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State | CA
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Zip | 95838-3466
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Country | US
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Telephone | 916-922-9868
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Fax |
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Provider Business Mailing Address
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Address Line | 4920 VIR MAR ST APT 51
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City | FAIR OAKS
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State | CA
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Zip | 95628-4667
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Country | US
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Telephone | 916-696-9343
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-BRYMVS
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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