Healthcare Provider Details

I. General information

NPI: 1639848468
Provider Name (Legal Business Name): ANALISA DOMINIQUE HUNT MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANALISA DOMINIQUE HERRERA

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 GENESEE AVE STE 710
LA JOLLA CA
92037-1218
US

IV. Provider business mailing address

9850 GENESEE AVE STE 710
LA JOLLA CA
92037-1218
US

V. Phone/Fax

Practice location:
  • Phone: 858-260-2977
  • Fax:
Mailing address:
  • Phone: 858-260-2977
  • Fax: 858-260-2978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP9501830
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0996903
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: