Individual
JOY PASSALACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
341 IRWIN LN, SANTA ROSA, CA 95401-5603
(707) 360-1504
Mailing address
341 IRWIN LN, SANTA ROSA, CA 95401-5603
(707) 360-1504
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
03/14/2022
Last updated
06/16/2025
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