Healthcare Provider Details

I. General information

NPI: 1083229652
Provider Name (Legal Business Name): GINA C TALANDRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3998 VISTA WAY STE E
OCEANSIDE CA
92056-4514
US

IV. Provider business mailing address

3998 VISTA WAY STE E
OCEANSIDE CA
92056-4514
US

V. Phone/Fax

Practice location:
  • Phone: 760-295-9830
  • Fax: 760-295-9866
Mailing address:
  • Phone: 760-295-9830
  • Fax: 760-295-9866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN252111
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95429543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: