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Individual

JOANNA KRISTINE AFFOLTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1904 RICHLAND AVE, CERES, CA 95307-4562
(209) 300-8800
Mailing address
24240 AWAHANEE RD, SONORA, CA 95370-8333
(209) 694-6004

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95053961
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95053961
REGISTERED NURSE
CA
Enumeration date
05/06/2019
Last updated
05/06/2019
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