Provider Demographics
NPI:1992227805
Name:HO, JOHANNA (PA-C)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:HO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27206 CALAROGA AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4300
Mailing Address - Country:US
Mailing Address - Phone:510-732-5731
Mailing Address - Fax:510-732-5739
Practice Address - Street 1:27206 CALAROGA AVE STE 206
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4300
Practice Address - Country:US
Practice Address - Phone:510-732-5731
Practice Address - Fax:510-732-5739
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54591363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant