Individual
JOEHNIS GERRELL JOYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5063 MAPLE RD, VACAVILLE, CA 95687-9468
(540) 993-3422
Mailing address
5050 LAGUNA BLVD STE 112, ELK GROVE, CA 95758-4151
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
RBT-25-412041
TX
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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