Provider Demographics
NPI:1104681139
Name:LONIGAN, JOLEEN
Entity type:Individual
Prefix:
First Name:JOLEEN
Middle Name:
Last Name:LONIGAN
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 1:3104 O ST # 355
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6519
Mailing Address - Country:US
Mailing Address - Phone:916-734-0436
Mailing Address - Fax:
Practice Address - Street 1:1881 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-8083
Practice Address - Country:US
Practice Address - Phone:757-683-4297
Practice Address - Fax:757-683-5253
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program