Provider Demographics
NPI:1528743697
Name:ESCALA, GRETHEL JOY ROA (MSN, BSN, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:GRETHEL JOY
Middle Name:ROA
Last Name:ESCALA
Suffix:
Gender:F
Credentials:MSN, BSN, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 CLUB DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94592-1187
Mailing Address - Country:US
Mailing Address - Phone:707-592-7796
Mailing Address - Fax:
Practice Address - Street 1:2200 TUOLUMNE ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2523
Practice Address - Country:US
Practice Address - Phone:707-644-7401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2025-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022387363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner