Provider Demographics
NPI:1902810948
Name:PERRON, JOANNE LORENE (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:LORENE
Last Name:PERRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2121
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-2121
Mailing Address - Country:US
Mailing Address - Phone:831-647-3190
Mailing Address - Fax:831-373-1007
Practice Address - Street 1:2 UPPER RAGSDALE DR
Practice Address - Street 2:STE B110
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5736
Practice Address - Country:US
Practice Address - Phone:831-647-3190
Practice Address - Fax:831-373-1007
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63474207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF92195Medicare UPIN
CA00G634740Medicare ID - Type Unspecified