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1260 Morena Blvd Ste 100 San Diego CA 92110-3850 | |
| (619) 232-4357 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Licensed Practical Nurse |
| Location | 1260 Morena Blvd Ste 100, San Diego, California |
| Authorized Official Name and Position | Tessa Sanchez (LEAD HR SPECIALIST -ONBOARDING) |
| Authorized Official Contact | 6192750822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1260 Morena Blvd San Diego CA 92110-3889 Ph: (619) 232-4357 | 1260 Morena Blvd Ste 100 San Diego CA 92110-3850 Ph: (619) 232-4357 |
| NPI Number | 1477175883 |
|---|---|
| Provider Enumeration Date | 05/08/2020 |
| Last Update Date | 10/14/2021 |
| Certification Date | 10/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477175883 | NPI | - | NPPES |
| 201902804LPN | Other | OR | LICENSE PRACTICAL NURSE |
| 719792 | Other | CA | CALIFORNIA BOARD OF VOCATIONAL NURSING AND PSYCHIATRIC TECHNICIANS |
| VN719792 | Other | CA | LICENSE VOCATIONAL NURSE |
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