Provider Demographics
NPI:1104082965
Name:JOHANNI, JAY ALLAN (RN)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:ALLAN
Last Name:JOHANNI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SAINT JOSEPHS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3255
Mailing Address - Country:US
Mailing Address - Phone:415-833-3727
Mailing Address - Fax:
Practice Address - Street 1:350 SAINT JOSEPHS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3255
Practice Address - Country:US
Practice Address - Phone:415-833-3727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA425559163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development