Provider Demographics
NPI:1285609610
Name:PADILLA, JOANNA LYNN (NP)
Entity type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:LYNN
Last Name:PADILLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 TORRANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3416
Mailing Address - Country:US
Mailing Address - Phone:310-792-8317
Mailing Address - Fax:310-540-9587
Practice Address - Street 1:601 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-3416
Practice Address - Country:US
Practice Address - Phone:310-792-8317
Practice Address - Fax:310-540-9587
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN359326363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily