Healthcare Provider Details

I. General information

NPI: 1720993967
Provider Name (Legal Business Name): ARIANA JUAREZ-MONCADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 SILVERADO ST STE 203
LA JOLLA CA
92037-4524
US

IV. Provider business mailing address

4042 OHIO ST
SAN DIEGO CA
92104-2608
US

V. Phone/Fax

Practice location:
  • Phone: 858-412-5141
  • Fax:
Mailing address:
  • Phone: 480-636-6292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95040832
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: