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NPI Code Detail

MEDICARE: SERENA MCDONALD-NIXON

MEDICARE: SERENA MCDONALD-NIXON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner714574GA

General Provider Information

NPI Number : 1376054841
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERENA MCDONALD-NIXON
Provider Business Mailing Address
First Line : 490 N GRAPE ST
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3079
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 490 N GRAPE ST
Second Line :
City : ESCONDIDO
State : CA
Zip : 92025-3079
Country : US
Telephone Number : 619-275-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2017
Last Update Date : 05/19/2026

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Directions to “ SERENA MCDONALD-NIXON ” Practice Location

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