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MRS. JOHANNA GREEN-JACOB NURSE PRACTITIONER
NPI 1609863968
Nurse Practitioner - Family in San Diego, CA

Active since October 03, 2005
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102(619) 515-2300(619) 906-4564 Get Directions Write a Review

NPPES record last updated: February 25, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Johanna Green-jacob Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. JOHANNA GREEN-JACOB NURSE PRACTITIONER (NPI 1609863968) is an individual family provider in San Diego, California, licensed in California (13014) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1609863968
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. JOHANNA GREEN-JACOBCredential: NURSE PRACTITIONER
Location Address823 GATEWAY CENTER WAYSan Diego, CA 92102-4541
Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 515-2300 · Fax (619) 906-4564
Phone(619) 515-2300
Fax(619) 906-4564
Sole ProprietorNo
Enumeration DateOctober 3, 2005
Last NPPES UpdateFebruary 25, 2014
✔ NPI 1609863968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 13014
823 GATEWAY CENTER WAY, San Diego, CA 92102
Open in Google Maps ↗

Other Identifiers 1

OtherPTANCA · Wnp13014a

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN KERMOIAN YASZAY NP
Nurse Practitioner (Family)
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
MR. ALEJANDRO R BASCON CERTIFIED
Counselor (Addiction (Substance Use Disorder))
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
BRITANY RODARTE
Dietitian, Registered
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
MISS KATIE LYNN WOOD LAADC
Counselor (Addiction (Substance Use Disorder))
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 876-4462
CARLY MOORE
Social Worker
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 906-4623
MYRNA ZAVALA MOLINA PA
Physician Assistant
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
ANNE MARIA LEISTIKOW
Dental Hygienist
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2323
ANNA FADEM MFTI
Marriage & Family Therapist
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johanna Green-jacob's NPI number?

The NPI number for Johanna Green-jacob is 1609863968. It was assigned to this individual provider in the NPPES registry on October 3, 2005.

Where is Johanna Green-jacob located?

Johanna Green-jacob practices at 823 Gateway Center Way, San Diego, CA 92102. The listed phone number is (619) 515-2300.

What is Johanna Green-jacob's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Johanna Green-jacob was last updated on February 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.