Healthcare Provider Details

I. General information

NPI: 1598561581
Provider Name (Legal Business Name): VANESSA JANICE ZAVALETA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 MEDICAL CENTER CT # CA91911
CHULA VISTA CA
91911-6617
US

IV. Provider business mailing address

732 BROADVIEW ST
SPRING VALLEY CA
91977-5524
US

V. Phone/Fax

Practice location:
  • Phone: 619-502-5800
  • Fax:
Mailing address:
  • Phone: 562-338-2731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95359875
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: