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NPI Code Detail

MEDICARE: MRS. JANNA BERNICE BROCCHINI FNP

MEDICARE: MRS. JANNA BERNICE BROCCHINI FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse751355CA
2363LF0000XFamily Nurse Practitioner20754CA

General Provider Information

NPI Number : 1386943546
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANNA BERNICE BROCCHINI FNP
Provider Business Mailing Address
First Line : 27011 S AUSTIN RD
Second Line :
City : RIPON
State : CA
Zip : 95366-9625
Country : US
Telephone Number : 209-599-3860
Fax Number : 209-599-9662
Provider Business Practice Location Address
First Line : 1262 E NORTH ST
Second Line :
City : MANTECA
State : CA
Zip : 95336-4962
Country : US
Telephone Number : 209-599-3860
Fax Number : 209-599-9662
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2011
Last Update Date : 09/28/2011

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