Healthcare Provider Details

I. General information

NPI: 1437190071
Provider Name (Legal Business Name): NEREMIAH JOAKIM SANCHEZ CASTANO MSN, RN (NP/CNS/PHN)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 HEALTH SCIENCES DR
LA JOLLA CA
92093-0658
US

IV. Provider business mailing address

3855 HEALTH SCIENCES DR
LA JOLLA CA
92093-0658
US

V. Phone/Fax

Practice location:
  • Phone: 858-822-7874
  • Fax:
Mailing address:
  • Phone: 858-822-7874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number624341
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number3191
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18985
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number66882
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: