Provider Demographics
NPI:1174936454
Name:ROYSTER, JAMES ARTHUR JR (FNP)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:ROYSTER
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:2100 POWELL ST
Mailing Address - Street 2:STE 900
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1844
Mailing Address - Country:US
Mailing Address - Phone:951-898-8515
Mailing Address - Fax:951-898-6209
Practice Address - Street 1:2083 COMPTON AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-7283
Practice Address - Country:US
Practice Address - Phone:951-898-8515
Practice Address - Fax:951-898-6209
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA22668363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty