Provider Demographics
NPI:1548014921
Name:CARLOS, JOY ANN ALONZO (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JOY ANN
Middle Name:ALONZO
Last Name:CARLOS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29220 SOUTHERNESS
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4399
Mailing Address - Country:US
Mailing Address - Phone:310-529-6846
Mailing Address - Fax:
Practice Address - Street 1:15955 PARAMOUNT BLVD STE A
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5144
Practice Address - Country:US
Practice Address - Phone:562-531-9806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily