Individual
MS. ANN KATHLEEN JAMGOCHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP10575
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA147118
PTAN
CA
Enumeration date
02/02/2007
Last updated
04/10/2015
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