Individual provider · Type 1 NPI
John William Hathaway Jr., FNP
Family Nurse Practitioner · Lake Elsinore, CA
NPI number
1497641732
Active
Practice location
31571 Canyon Estates Dr Ste 228
Lake Elsinore, CA 92532-0425
Mailing address
138 Bracebridge Rd
Riverside, CA 92506-6114
Other practice locations
- 4646 Brockton Ave Ste 202-4, Riverside, CA 92506-0172 · (951) 471-0200
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95035568 (CA) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1497641732
John William Hathaway Jr., FNP's National Provider Identifier is 1497641732, issued on Jun 13, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Lake Elsinore, CA. The record was last updated on May 11, 2026.