Healthcare Provider Details

I. General information

NPI: 1699403782
Provider Name (Legal Business Name): NANCY HUITZIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 6TH AVE STE 150
SAN DIEGO CA
92101-4370
US

IV. Provider business mailing address

1250 6TH AVE STE 150
SAN DIEGO CA
92101-4370
US

V. Phone/Fax

Practice location:
  • Phone: 619-895-2205
  • Fax:
Mailing address:
  • Phone: 619-895-2205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: