Provider Demographics
NPI:1083427785
Name:BOLES WHITLOW, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:BOLES WHITLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47192 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-6740
Mailing Address - Country:US
Mailing Address - Phone:805-570-3725
Mailing Address - Fax:
Practice Address - Street 1:47192 MONROE ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6740
Practice Address - Country:US
Practice Address - Phone:760-342-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-28
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula