Individual
NINA C JOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3000 Q ST, SACRAMENTO, CA 95816-7058
(916) 733-5700
(916) 733-5714
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0505P
NH
363AS0400X
Surgical Physician Assistant
Primary
PA21411
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30334232
—
NH
Enumeration date
07/10/2006
Last updated
02/04/2016
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