Healthcare Provider Details

I. General information

NPI: 1801881552
Provider Name (Legal Business Name): SERENA CHRISTINE ARTS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 GROSSMONT CENTER DR
LA MESA CA
91942-3019
US

IV. Provider business mailing address

1942 DENVER ST
SAN DIEGO CA
92110-3423
US

V. Phone/Fax

Practice location:
  • Phone: 619-740-4160
  • Fax: 619-740-4380
Mailing address:
  • Phone: 619-276-8481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number10769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: