Individual provider Active NPI

Joan Marie Veneman, NNP

  • Acute Care Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1770707481
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
308874 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4405
Phone
(209) 576-3737
Fax
(209) 576-3592
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 308874 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4405

Mailing address

1118 Wellesley Ave
Modesto, CA 95350-5044
Phone (209) 609-3683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
308874CAMDAcute Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770707481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 WELLESLEY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953505044",
            "telephone_number": "209-609-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504405",
            "telephone_number": "209-576-3737",
            "fax_number": "209-576-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEMAN",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "credential": "NNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "308874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.