Healthcare Provider Details

I. General information

NPI: 1831578251
Provider Name (Legal Business Name): SERINEH SAKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 10/08/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON H-200 MERCY CIRCLE
CAMP PENDLETON CA
92055-5191
US

IV. Provider business mailing address

PO BOX 551911
CAMP PENDLETON CA
92055-5191
US

V. Phone/Fax

Practice location:
  • Phone: 619-669-8196
  • Fax: 760-725-1515
Mailing address:
  • Phone: 619-669-8196
  • Fax: 760-725-1515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95044326
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: