Jessamine Joy Faustino-wong, MD | |
1301 Pinole Valley Rd, Pinole, CA 94564-1384 | |
(510) 243-4200 | |
Not Available |
Full Name | Jessamine Joy Faustino-wong |
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Gender | Female |
Speciality | Pediatrics |
Location | 1301 Pinole Valley Rd, Pinole, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134582265 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A150475 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
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Jessamine Joy Faustino-wong, MD 1301 Pinole Valley Rd, Pinole, CA 94564-1384 Ph: (510) 243-4200 | Jessamine Joy Faustino-wong, MD 1301 Pinole Valley Rd, Pinole, CA 94564-1384 Ph: (510) 243-4200 |
Dr. Preeti N. Dave, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1301 Pinole Valley Rd, Pinole, CA 94564 Phone: 510-243-4200 | |
Dr. Diana Harris Mahar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1301 Pinole Valley Rd, Dept. Of Pediatrics, Pinole, CA 94564 Phone: 510-243-4213 | |
Beverly Estes, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2160 Appian Way, Suite 100, Pinole, CA 94564 Phone: 510-724-8300 Fax: 510-724-8391 |