Healthcare Provider Details

I. General information

NPI: 1861782914
Provider Name (Legal Business Name): NANCY HOAGLAND - FUCHS R. N. - C. D. E
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9894 GENESEE AVE
LA JOLLA CA
92037-1296
US

IV. Provider business mailing address

FILE # 54433
LOS ANGELES CA
90074-4433
US

V. Phone/Fax

Practice location:
  • Phone: 858-626-5659
  • Fax:
Mailing address:
  • Phone: 858-784-5888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number20020266
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN668633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: