Provider Demographics
NPI:1255682373
Name:JO, ISA (FNP)
Entity type:Individual
Prefix:
First Name:ISA
Middle Name:
Last Name:JO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10666 CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-3103
Mailing Address - Country:US
Mailing Address - Phone:714-531-7930
Mailing Address - Fax:714-531-7997
Practice Address - Street 1:10666 CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-3103
Practice Address - Country:US
Practice Address - Phone:714-531-7930
Practice Address - Fax:714-531-7997
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO0991226363LF0000X
NYF337073363LF0000X
CA95013532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily