Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Johanna Green-Jacob, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1609863968

Mrs. Johanna Green-Jacob, NURSEPRACTITIONER is a Family Nurse Practitioner in San Diego, California. Licensed in California. Registered with an NPI since 2005.

Licensed in
CA
In the registry since
2005

Practice location Address checks out

823 Gateway Center Way
San Diego, CA 92102-4541
Phone: (619) 515-2300
Fax: (619) 906-4564
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 13014 (CA)

Record details

NPI number1609863968
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedOctober 3, 2005
Last updated in NPPESFebruary 25, 2014

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