Individual provider · Type 1 NPI
Joanne Amala Supersad, MD
Pediatric Adolescent Medicine Physician · Martinez, CA
NPI number
1013096148
Active
Practice location
200 Muir Rd
Martinez, CA 94553-4614
Mailing address
1800 Harrison St Fl 7
Oakland, CA 94612-3429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | G51939 (CA) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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About NPI 1013096148
Joanne Amala Supersad, MD's National Provider Identifier is 1013096148, issued on Nov 2, 2006. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Martinez, CA. The record was last updated on Jul 8, 2007.