Individual
MS. JOANNE MIYAUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8001 MADISON AVE, CITRUS HEIGHTS, CA 95610-7901
(916) 536-2420
(916) 985-7844
Mailing address
3400 DATA DR, PHYSICIAN SUPPORT SERVICES, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 19570
CA
363AM0700X
Medical Physician Assistant
Primary
PA19570
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0078350
MEDICAL
CA
Enumeration date
05/19/2008
Last updated
07/23/2014
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