Healthcare Provider Details

I. General information

NPI: 1457267528
Provider Name (Legal Business Name): GERALDINE ARNIEL REBOJA AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 EASTLAKE PKWY STE 102
CHULA VISTA CA
91915-2032
US

IV. Provider business mailing address

1741 EASTLAKE PKWY STE 102
CHULA VISTA CA
91915-2032
US

V. Phone/Fax

Practice location:
  • Phone: 888-316-2702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95041142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: