Individual
JOHANNA JETTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2999 REGENT ST STE 524, BERKELEY, CA 94705-2120
(510) 244-0446
Mailing address
3211 KING ST, BERKELEY, CA 94703-2434
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
95007955
CA
367A00000X
Advanced Practice Midwife
Primary
235935
CA
Other
Enumeration date
11/13/2017
Last updated
03/05/2026
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