Provider Demographics
NPI:1689402489
Name:GAERTNER, JOANNA L (RN)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:L
Last Name:GAERTNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:L
Other - Last Name:GARTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:285 N HOLLISTON AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1545
Mailing Address - Country:US
Mailing Address - Phone:650-766-4332
Mailing Address - Fax:
Practice Address - Street 1:100 S LOS ROBLES AVE # 501
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2453
Practice Address - Country:US
Practice Address - Phone:626-564-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95164135163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine