MRS. JOHANNA GREEN-JACOB (NPI# 1609863968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609863968 |
| Entity Type | Individual |
| Full Name | MRS. JOHANNA GREEN-JACOB |
| Credential | NURSE PRACTITIONER |
| Practice Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6195152300 |
| Practice Fax Number | 6199064564 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6199064564 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2014-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
13014 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | WNP13014A | PTAN | 01 |
| Street Address |
823 GATEWAY CENTER WAY |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92102-4541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376104570 | Joyce Catherine Neville | Speech-Language Pathologist | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-06-27 |
| 1508426529 | Fatimah Nadimi | Counselor | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-06-20 |
| 1700440781 | Family Health Centers of San Diego, Inc. | Clinic/Center | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-04-25 |
| 1619531696 | Family Health Centers of San Diego, Inc. | Clinic/Center | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-04-25 |
| 1952863631 | Danielle Julia Sills | Counselor | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-04-02 |
| 1275098626 | Maria Josefa Dorronsoro | Counselor | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2019-02-08 |
| 1104397934 | Lakiesha Maria Wilks | Social Worker | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2018-12-05 |
| 1366911901 | Leticia Isabel Rico-raya | Marriage & Family Therapist | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2018-11-13 |
| 1871061812 | Carmen Elia Suarez | Counselor | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2018-11-07 |
| 1740765866 | Jennifer Kay Simpson | Social Worker | 823 Gateway Center Way, San Diego, CA 92102-4541 | 2018-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766698 | Daniela Tablas | Behavioral Analyst | 303 47th St Spc D-22, San Diego, CA 92102 | 2020-09-30 |
| 1649745712 | Juliet Lao Kurek | Pharmacist | 2121 Imperial Avenue, San Diego, CA 92102 | 2018-10-04 |
| 1851887020 | Monique Joseph | Counselor | 2410 E. Street, San Diego, CA 92102 | 2018-07-10 |
| 1184166316 | Elise Blanton-hubbard | Counselor | 1850 Dale St, San Diego, CA 92102 | 2016-11-04 |
| 1699221416 | Kari Judith Medina | Student in an Organized Health Care Education/Training Program | 1199 34th Street Apt 11, San Diego, CA 92102 | 2016-08-31 |
| 1942674536 | Caitlin Hillary Dablow | Speech-Language Pathologist | 1201 34th Street, San Diego, CA 92102 | 2015-11-19 |
| 1134508179 | Jonathan Waters | Military Health Care Provider | 1233 22nd Street, Unit 8, San Diego, CA 92102 | 2015-05-22 |
| 1871989913 | Abraham Greenberg | Pediatrics | 15 Balfour Street, Jerusalem, ISRAEL 92102 | 2015-04-15 |
| 1023421021 | Elmira Aghdam | Chiropractor | 5030 Bonita Rd Ste#b, Bonita, CA 92102 | 2014-06-06 |
| 1487092540 | Sherry Scott | Marriage & Family Therapist | 995 Gateway Center Drive #300, San Diego, CA 92102 | 2013-06-11 |
| Find all providers in zip 92102 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203097 | Rebecca Dolores Garcia | Nurse Practitioner | 2440 Curlew St, San Diego, CA 92101-1327 | 2020-10-20 |
| 1003415472 | Ryanleo Flores | Nurse Practitioner | 2017 1st Avenue, Suite 301, San Diego, CA 92101 | 2020-10-18 |
| 1083226245 | Allison Floyd | Nurse Practitioner | 3652 Texas St, San Diego, CA 92104-4044 | 2020-08-19 |
| 1386255248 | Helen Hyeyoung Hong | Nurse Practitioner | 5140 Caminito Exquisito, San Diego, CA 92130-2852 | 2020-08-13 |
| 1134747595 | Dawn Elyse Rose | Nurse Practitioner | 8260 Mira Mesa Blvd Ste A, San Diego, CA 92126-2662 | 2020-07-10 |
| 1982232591 | John Meier | Nurse Practitioner | 3745 Riviera Dr Apt 10, San Diego, CA 92109-6661 | 2020-03-30 |
| 1013543008 | Alex Choi Mara | Nurse Practitioner | 5248 Zephyr Ln Unit 24, San Diego, CA 92120-2749 | 2020-03-21 |
| 1669005021 | Katlyn Ann Hartman | Nurse Practitioner | 1951 4th Ave, San Diego, CA 92101-2374 | 2020-02-13 |
| 1245876101 | Katherine Baber | Nurse Practitioner | 3671 Fifth Ave, San Diego, CA 92103-4218 | 2019-11-25 |
| 1922644095 | Taiko Harris | Nurse Practitioner | 13592 Bolero Way, San Diego, CA 92130-7006 | 2019-11-22 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.