Provider Demographics
NPI:1427087618
Name:THORSHEIM, JOANN (NP)
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:THORSHEIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:NASRALLAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:68860 PEREZ RD STE J
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7248
Mailing Address - Country:US
Mailing Address - Phone:760-328-4499
Mailing Address - Fax:760-328-1050
Practice Address - Street 1:68860 PEREZ RD STE J
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7248
Practice Address - Country:US
Practice Address - Phone:760-328-4499
Practice Address - Fax:760-328-1050
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP1114363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR95100Medicare UPIN